Department of Pediatrics, Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu, 600008, India.
HOD & Professor, Department of Pediatric Intensive Care, Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu, India.
Indian J Pediatr. 2022 Sep;89(9):879-884. doi: 10.1007/s12098-021-03954-8. Epub 2021 Nov 24.
To know the clinical presentation and outcome of children with pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV- 2 (PIMS-TS) at a pediatric tertiary care center in Chennai.
Clinical and biochemical parameters of 65 children with PIMS-TS treated between July and October 2020 were studied. All children had their COVID RT-PCR and IgG COVID antibodies tests done.
Mean age of the study group was 5.65 ± 3.68 y. Fever with red eyes, rash, vomiting, abdominal pain, and shock were common presenting features. Sixty percent of the study group had Kawasaki/incomplete Kawasaki features. Sixty-seven percent of the study group had coronary dilatation, 41% presented with shock, and 25% had left ventricular dysfunction. Coronary aneurysms were documented in 58% of the study group (z score more than 2.5). Respiratory presentation with pneumonia was seen in 10%. Four children presented with acute abdomen. Acute kidney injury, acute liver failure, hemolysis, pancytopenia, macrophage activation syndrome, encephalopathy, and multiorgan dysfunction syndrome (MODS) were other features. Forty-three percent required noninvasive oxygen support and 15.4% required mechanical ventilation. Intravenous immunoglobulin (73.8%) and methylprednisolone (49.8%) were used for therapy. Mortality in the study was 6%, which was due to MODS.
Acute febrile illness with mucocutaneous and gastrointestinal manifestations should have PIMS-TS as a possible differential diagnosis and needs evaluation with inflammatory markers and SARS-CoV-2 antibodies.
了解钦奈一家儿科三级护理中心与 SARS-CoV-2 相关的儿童多系统炎症综合征（PIMS-TS）患儿的临床表现和转归。
研究了 2020 年 7 月至 10 月期间治疗的 65 例 PIMS-TS 患儿的临床和生化参数。所有患儿均进行了 COVID RT-PCR 和 IgG COVID 抗体检测。
研究组的平均年龄为 5.65±3.68 岁。发热伴眼红、皮疹、呕吐、腹痛和休克是常见的首发症状。研究组 60%有川崎病/不完全川崎病特征。研究组 67%有冠状动脉扩张，41%出现休克，25%有左心室功能障碍。研究组 58%（z 评分大于 2.5）有冠状动脉瘤。10%有呼吸道表现为肺炎。4 例患儿表现为急腹症。急性肾损伤、急性肝衰竭、溶血、全血细胞减少、巨噬细胞活化综合征、脑病和多器官功能障碍综合征（MODS）是其他特征。43%需要非侵入性氧支持，15.4%需要机械通气。73.8%的患儿使用了静脉注射免疫球蛋白，49.8%的患儿使用了甲基强的松龙。研究组的死亡率为 6%，这是由于 MODS。
急性发热性疾病伴黏膜皮肤和胃肠道表现时，应将 PIMS-TS 作为可能的鉴别诊断，并需要通过炎症标志物和 SARS-CoV-2 抗体进行评估。
