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根据患者年龄分析与SARS-CoV-2相关的儿童多系统炎症综合征的独特表型:一项单中心经验

Distinctive Phenotype of Multisystem Inflammatory Syndrome in Children Associated with SARS-CoV-2 According to Patients' Age: A Monocentric Experience.

作者信息

Giannattasio Antonietta, Orlando Francesca, D'Anna Carolina, Muzzica Stefania, Angrisani Francesca, Acierno Sabrina, Paciello Francesca, Savoia Fabio, Tardi Maria, Mauro Angela, Martemucci Luigi, Tipo Vincenzo

机构信息

Pediatric Emergency and Short Stay Unit, Santobono-Pausilipon Children's Hospital, 80121 Naples, Italy.

Pediatric Department, Santobono-Pausilipon Children's Hospital, 80122 Naples, Italy.

出版信息

Children (Basel). 2022 Mar 27;9(4):468. doi: 10.3390/children9040468.

DOI:10.3390/children9040468
PMID:35455512
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9030269/
Abstract

Background: Multisystem inflammatory syndrome in children (MIS-C) is a disease temporally related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and it is characterized by fever, conjunctival injections, rash, gastrointestinal symptoms, and cardiovascular complications. We evaluated the clinical presentation, laboratory findings, imaging features, therapeutic interventions, and hospital course of a monocentric cohort, and we analyzed these findings according to two age groups. Methods: Patients with MIS-C admitted to a Tertiary Care Pediatric Hospital from November 2020 to November 2021 were considered for the enrollment. Results: Overall, 35 consecutive patients were included. Most of the children did not require intensive care unit at the admission. The clinical presentation of MIS-C slightly differs according to age groups. Mucocutaneus involvement was more frequent in younger patients, while abdominal symptoms were present in 54% of patients aged less than 5 years and in 95% of patients aged more than 5 years (p < 0.05). In addition, the number of cases with troponin above the normal reference value was significantly higher in older patients (77%) compared to younger cases (15%) (p < 0.01). Conclusions: MIS-C is a new emerging condition and represents a challenge to pediatricians due to the severity of presentation. Further studies to better characterize the long-term outcome of MIS-C patients are mandatory.

摘要

背景

儿童多系统炎症综合征(MIS-C)是一种与严重急性呼吸综合征冠状病毒2(SARS-CoV-2)在时间上相关的疾病,其特征为发热、结膜充血、皮疹、胃肠道症状和心血管并发症。我们评估了一个单中心队列的临床表现、实验室检查结果、影像学特征、治疗干预措施及住院病程,并根据两个年龄组对这些结果进行了分析。方法:纳入2020年11月至2021年11月入住一家三级护理儿童医院的MIS-C患者。结果:共纳入35例连续患者。大多数儿童入院时不需要重症监护。MIS-C的临床表现因年龄组而异。皮肤黏膜受累在较年轻患者中更为常见,而腹部症状在5岁以下患者中占54%,在5岁以上患者中占95%(p<0.05)。此外,肌钙蛋白高于正常参考值的病例数在老年患者中(77%)显著高于年轻患者(15%)(p<0.01)。结论:MIS-C是一种新出现的疾病,因其临床表现的严重性对儿科医生构成挑战。必须进行进一步研究以更好地描述MIS-C患者的长期预后。

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本文引用的文献

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Brugada Pattern in a Child with Severe SARS-CoV-2 Related Multisystem Inflammatory Syndrome.一名患有严重新型冠状病毒2型相关多系统炎症综合征儿童的Brugada波型
Pediatr Rep. 2021 Sep 1;13(3):504-510. doi: 10.3390/pediatric13030058.
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Treatment of Multisystem Inflammatory Syndrome in Children.儿童多系统炎症综合征的治疗。
N Engl J Med. 2021 Jul 1;385(1):11-22. doi: 10.1056/NEJMoa2102968. Epub 2021 Jun 16.
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Silent RSV in infants with SARS-CoV-2 infection: A case series.新型冠状病毒肺炎(SARS-CoV-2)感染婴儿中的呼吸道合胞病毒(RSV)隐性感染:病例系列
Pediatr Pulmonol. 2021 Sep;56(9):3044-3046. doi: 10.1002/ppul.25465. Epub 2021 May 25.
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Is COVID-19 a hyperferritinemic syndrome in children?新冠病毒感染在儿童中是一种高铁蛋白血症综合征吗?
Clin Chem Lab Med. 2021 May 20;59(11):e409-e412. doi: 10.1515/cclm-2021-0373. Print 2021 Oct 26.
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The importance of heart and brain imaging in children and adolescents with Multisystem Inflammatory Syndrome in Children (MIS-C).儿童多系统炎症综合征(MIS-C)中心脏和脑部成像的重要性。
Rheumatol Int. 2021 Jun;41(6):1037-1044. doi: 10.1007/s00296-021-04845-z. Epub 2021 Apr 17.
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Eur J Pediatr. 2021 Jul;180(7):2019-2034. doi: 10.1007/s00431-021-03993-5. Epub 2021 Feb 18.
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