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儿童多系统炎症综合征与新型冠状病毒肺炎相关的临床特征及近期结局:一项多中心研究

Clinical Profile and Immediate Outcome of Multisystem Inflammatory Syndrome in Children Associated with COVID-19: A Multicentric Study.

作者信息

Sethy Geetanjali, Mishra Bibhudatta, Jain Mukesh Kumar, Patnaik Sibabratta, Mishra Reshmi, Behera Jyoti Ranjan, Sahoo Bandya, Behera Narendra

机构信息

Department of Pediatrics, PRN Medical College, Baripada, Odisha, India.

Department of Pediatrics, Jagannath Hospital, Bhubaneswar, Odisha, India.

出版信息

J Glob Infect Dis. 2021 Nov 26;13(4):159-163. doi: 10.4103/jgid.jgid_85_21. eCollection 2021 Oct-Dec.

Abstract

INTRODUCTION

Following an asymptomatic or mildly symptomatic coronavirus disease (COVID-19), otherwise healthy children may develop serious manifestations in the form of cardiac, neurological, respiratory, gastrointestinal, and dermatologic dysfunction. Many such cases were being observed in Odisha, an eastern state of India, and have been reported from different health-care facilities. We related these unexplained serious manifestations to multisystem inflammatory syndrome associated with COVID-19 (MIS-C) and planned this study.

METHODS

This retrospective observational study was carried out at the following three tertiary care centers: Kalinga Institute of Medical Sciences, Bhubaneswar; MKCG Medical College, Berhampur; and Jagannath Hospital, Bhubaneswar. The study population included all children aged from 1 month to 18 years admitted to the hospitals with MIS-C according to the WHO diagnostic criteria. All the data were analyzed by SPSS software.

RESULTS

A total of 21 children were included in our study. Majority of the cases were male (76.2%), and the predominant age group was 6-10 years (47.6%). Common symptoms and signs in our observation included fever, pain abdomen, seizure, and hypotension. Most of these cases were positive for severe acute respiratory syndrome coronavirus antibody (80.95%). Response to immunotherapy was dramatic. Mortality (9%) of our study was higher than 1.8%-3% from that of Western literature. None of our patients had coronary abnormality, while two patients had mild cardiac dysfunction at discharge comparable to that of other studies.

CONCLUSION

MIS-C following exposure to COVID-19 infection in children is a clinical syndrome, which needs early suspicion and appropriate intervention to prevent mortality.

摘要

引言

在感染无症状或症状轻微的冠状病毒病(COVID-19)后,原本健康的儿童可能会出现心脏、神经、呼吸、胃肠和皮肤功能障碍等严重表现。印度东部奥里萨邦观察到许多此类病例,并已从不同医疗机构报告。我们将这些不明原因的严重表现与COVID-19相关的多系统炎症综合征(MIS-C)联系起来,并开展了本研究。

方法

这项回顾性观察研究在以下三个三级医疗中心进行:布巴内斯瓦尔的卡林加医学科学研究所;伯勒姆布尔的MKCG医学院;以及布巴内斯瓦尔的贾格纳特医院。研究人群包括所有根据世界卫生组织诊断标准因MIS-C入院的1个月至18岁儿童。所有数据均采用SPSS软件进行分析。

结果

我们的研究共纳入21名儿童。大多数病例为男性(76.2%),主要年龄组为6 - 10岁(47.6%)。我们观察到的常见症状和体征包括发热、腹痛、惊厥和低血压。这些病例中的大多数严重急性呼吸综合征冠状病毒抗体检测呈阳性(80.95%)。免疫治疗反应显著。我们研究中的死亡率(9%)高于西方文献报道的1.8% - 3%。我们的患者均无冠状动脉异常,而两名患者出院时存在轻度心脏功能障碍,与其他研究情况相当。

结论

儿童感染COVID-19后出现的MIS-C是一种临床综合征,需要早期怀疑并进行适当干预以预防死亡。

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