Solanki Reema, Gupta Aparajita, Roy Shuvendu, Pal Sunandan, Khan Mohd Faisal
Classified Specialist (Pediatrics), Command Hospital (Eastern Command), Kolkata, India.
Classified Specialist (Pediatrics) & Pediatric Neurologist, Command Hospital (Eastern Command), Kolkata, India.
Med J Armed Forces India. 2022 Sep;78(Suppl 1):S133-S138. doi: 10.1016/j.mjafi.2021.10.017. Epub 2021 Dec 16.
The objective of the study is to describe the presentation, treatment and outcomes of children with multisystem inflammatory syndrome with COVID-19 (MIS-C) in a tertiary care centre in Eastern India.
Retrospective data of children diagnosed with MIS-C during the SARS CoV-2 pandemic were obtained from hospital records. Clinical details, laboratory profile, treatment protocol and outcomes of children with MIS-C between 01 Nov 2020 and 30 June 2021 were analysed.
Ten children (7 males) with a mean age of 6.8 years (median age 5.5 years, interquartile range 3.75-9.5) were analysed. COVID-19 RT-PCR was negative in all patients, whereas the IgG COVID antibody was positive in all children (100%). Seven children (7/10) had a history of contact with SARS CoV-2-positive adults. Five (5/10) children presented with cardiogenic shock. All children had evidence of a hyperinflammatory syndrome. Nine children (9/10) had predominant gastrointestinal and cardiovascular involvement. None had echocardiographic evidence of coronary dilatation or aneurysms either on admission or on follow-up. The elevated neutrophil lymphocyte ratio and D-dimer were found in all patients. All children responded to immunomodulatory treatment. None had residual deficit on discharge or at 4-week follow-up. There was no mortality.
Children with MIS-C have good prognosis if early immunomodulatory treatment is instituted. Further prospective studies for long-term outcomes in children with MIS-C are required it being a novel entity recently described.
本研究的目的是描述印度东部一家三级医疗中心中患有新型冠状病毒肺炎多系统炎症综合征（MIS-C）的儿童的临床表现、治疗及预后情况。
从医院记录中获取在严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行期间被诊断为MIS-C的儿童的回顾性数据。分析了2020年11月1日至2021年6月30日期间MIS-C患儿的临床细节、实验室检查结果、治疗方案及预后情况。
分析了10名儿童（7名男性），平均年龄6.8岁（中位年龄5.5岁，四分位间距3.75 - 9.5岁）。所有患者的新型冠状病毒肺炎逆转录聚合酶链反应（COVID-19 RT-PCR）均为阴性，而所有儿童的新冠病毒IgG抗体均为阳性（100%）。7名儿童（7/10）有接触SARS-CoV-2阳性成人的病史。5名（5/10）儿童出现心源性休克。所有儿童均有炎症综合征的证据。9名儿童（9/10）主要累及胃肠道和心血管系统。入院时及随访时均无儿童有超声心动图显示冠状动脉扩张或动脉瘤的证据。所有患者均发现中性粒细胞淋巴细胞比值及D-二聚体升高。所有儿童对免疫调节治疗均有反应。出院时或4周随访时均无残留缺陷。无死亡病例。
如果早期进行免疫调节治疗，MIS-C患儿预后良好。鉴于MIS-C是最近才被描述的新病种，需要进一步开展关于MIS-C患儿长期预后的前瞻性研究。
