Mehra Bharat, Pandey Mukul, Gupta Dhiren, Oberoi Tania, Jerath Nameet, Sharma Rachna, Lal Naresh, Singha Chandrasekhar, Malhotra Bhavana, Manocha Vinamra, Simalti Ashish K, Arya Yogesh, Dugaya Sandeep K, Kalra Swati, Chitkara Amar J, Sachdev Anil, Gupta Neeraj
Department of Pediatric Intensive Care, Max Super Speciality Hospital, New Delhi, India.
Department of Pediatrics, St Stephens Hospital, New Delhi, India.
Indian J Crit Care Med. 2021 Oct;25(10):1176-1182. doi: 10.5005/jp-journals-10071-23996.
Multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new entity affecting a small percentage of children during the COVID-19 pandemic.
Demography, clinical, and laboratory variables of children admitted from April to September 2020 with MIS-C were studied retrospectively at eight hospitals in Delhi, India.
We identified 120 patients [median age: 7 years (interquartile range (IQR): 4-10)] with male-to-female ratio of 2.3:1. Overall, 73 out of 120 children (60.8%) presented with shock, 63 (52.5%) required inopressor support, and 51 (43%) required respiratory support. We categorized the cohort into three observed clinical phenotypes: MIS-C with shock ( = 63), MIS-C with Kawasaki disease (KD) ( = 23), and MIS-C without shock and KD ( = 34). Atypical presentations were hypothermia, orchitis, meningoencephalitis, demyelination, polyneuropathy, pancreatitis, and appendicitis. Ninety-four percent had laboratory evidence of SARS-CoV-2 (78.3%, seropositive and 15.8%, RT-PCR positive). The median C-reactive protein (CRP) was 136 mg/L (IQR, 63.5-212.5) and ferritin was 543 ng/mL (IQR, 225-1,127). More than 90% received immunomodulatory therapy (intravenous immunoglobulins and/or steroids) with an excellent outcome (96% survived). CRP and absolute neutrophil count (ANC) were correlated statistically with severity.
MIS-C data from Delhi are presented. Rising CRP and ANC predict the severe MIS-C.
Mehra B, Pandey M, Gupta D, Oberoi T, Jerath N, Sharma R COVID-19-associated Multisystem Inflammatory Syndrome in Children: A Multicentric Retrospective Cohort Study. Indian J Crit Care Med 2021;25(10):1176-1182.
与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）相关的儿童多系统炎症综合征（MIS-C）是在新型冠状病毒肺炎（COVID-19）大流行期间影响一小部分儿童的一种新病症。
对2020年4月至9月在印度德里的八家医院收治的患有MIS-C的儿童的人口统计学、临床和实验室变量进行回顾性研究。
我们确定了120例患者[中位年龄：7岁（四分位间距（IQR）：4 - 10岁）]，男女比例为2.3:1。总体而言，120名儿童中有73名（60.8%）出现休克，63名（52.5%）需要血管活性药物支持，51名（43%）需要呼吸支持。我们将该队列分为三种观察到的临床表型：伴有休克的MIS-C（n = 63）、伴有川崎病（KD）的MIS-C（n = 23）以及不伴有休克和KD的MIS-C（n = 34）。非典型表现为体温过低、睾丸炎、脑膜脑炎、脱髓鞘、多发性神经病、胰腺炎和阑尾炎。94%的患者有SARS-CoV-2的实验室证据（78.3%血清学阳性，15.8%逆转录聚合酶链反应（RT-PCR）阳性）。C反应蛋白（CRP）中位数为136mg/L（IQR，63.5 - 212.5），铁蛋白为543ng/mL（IQR，225 - 1127）。超过90%的患者接受了免疫调节治疗（静脉注射免疫球蛋白和/或类固醇），预后良好（96%存活）。CRP和绝对中性粒细胞计数（ANC）与严重程度具有统计学相关性。
展示了来自德里的MIS-C数据。CRP升高和ANC升高预示着严重MIS-C。
Mehra B, Pandey M, Gupta D, Oberoi T, Jerath N, Sharma R 儿童COVID-19相关多系统炎症综合征：一项多中心回顾性队列研究。《印度重症监护医学杂志》2021；25(10):1176 - 1182。
