Department of Paediatrics, Clinical Sciences Lund, Lund University, Lund, Sweden.
Wallenberg Centre for Molecular Medicine, Lund University, Lund, Sweden.
Acta Paediatr. 2022 Feb;111(2):354-362. doi: 10.1111/apa.16191. Epub 2021 Dec 1.
Our aim was to describe the outcomes of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19.
This national, population-based, longitudinal, multicentre study used Swedish data that were prospectively collected between 1 December 2020 and 31 May 2021. All patients met the World Health Organization criteria for MIS-C. The outcomes 2 and 8 weeks after diagnosis are presented, and follow-up protocols are suggested.
We identified 152 cases, and 133 (87%) participated. When followed up 2 weeks after MIS-C was diagnosed, 43% of the 119 patients had abnormal results, including complete blood cell counts, platelet counts, albumin levels, electrocardiograms and echocardiograms. After 8 weeks, 36% of 89 had an abnormal patient history, but clinical findings were uncommon. Echocardiogram results were abnormal in 5% of 67, and the most common complaint was fatigue. Older children and those who received intensive care were more likely to report symptoms and have abnormal cardiac results.
More than a third (36%) of the patients had persistent symptoms 8 weeks after MIS-C, and 5% had abnormal echocardiograms. Older age and higher levels of initial care appeared to be risk factors. Structured follow-up visits are important after MIS-C.
描述与 COVID-19 相关的儿童多系统炎症综合征 (MIS-C) 的结局。
本项全国性、基于人群的纵向多中心研究使用了 2020 年 12 月 1 日至 2021 年 5 月 31 日期间前瞻性收集的瑞典数据。所有患者均符合世界卫生组织 (WHO) MIS-C 标准。本文介绍了诊断后 2 周和 8 周的结局,并提出了随访方案。
我们共确定了 152 例病例,其中 133 例(87%)参与了研究。在 MIS-C 诊断后 2 周进行随访时,119 例患者中有 43%的检测结果异常,包括全血细胞计数、血小板计数、白蛋白水平、心电图和超声心动图。8 周后,89 例中有 36%的患者有异常病史,但临床发现并不常见。67 例中有 5%的超声心动图结果异常,最常见的主诉是疲劳。年龄较大的儿童和接受重症监护的儿童更有可能出现症状和心脏检查异常。
超过三分之一(36%)的患者在 MIS-C 后 8 周仍有持续症状,5%的患者有异常超声心动图结果。年龄较大和初始治疗水平较高似乎是危险因素。MIS-C 后进行结构化随访非常重要。