Giannattasio Antonietta, Maglione Marco, D'Anna Carolina, Muzzica Stefania, Pappacoda Serena, Lenta Selvaggia, Di Mita Onorina, Ranucci Giusy, Mandato Claudia, Tipo Vincenzo
Pediatric Emergency Unit, Santobono-Pausilipon Children's Hospital, AORN, 80130 Naples, Italy.
Medical Department, University of Salerno, 84084 Salerno, Italy.
Children (Basel). 2022 Apr 18;9(4):575. doi: 10.3390/children9040575.
Liver and pancreatic involvement in children with Multisystem Inflammatory Syndrome related to SARS-CoV-2 (MIS-C) has been poorly investigated so far. We reviewed a cohort of MIS-C patients to analyze the prevalence of acute liver injury (ALI) and pancreatic injury and their correlation with clinical outcomes. Demographic, clinical, laboratory and imaging features of children with MIS-C at admission and during hospital stay were prospectively collected. Fifty-five patients (mean age 6.5 ± 3.7 years) were included. At admission, 16 patients showed ALI and 5 had increased total serum lipase. During observation, 10 more patients developed ALI and 19 more subjects presented raised pancreatic enzymes. In comparison to those with normal ALT, subjects with ALI were significantly older ( = 0.0004), whereas pancreatic involvement was associated to a longer duration of hospital stay compared with patients with normal pancreatic enzymes ( = 0.004). Time between hospital admission and onset of ALI was shorter compared to the onset of raised pancreatic enzymes (3.2 ± 3.9 versus 5.3 ± 2.7 days, respectively; = 0.035). Abdominal ultrasound showed liver steatosis in 3/26 (12%) and hepatomegaly in 6/26 (16%) patients with ALI; 2 patients presented enlarged pancreas. Although liver and pancreatic involvement is commonly observed in MIS-C patients, it is mild in most cases with a complete recovery.
迄今为止，对于与新型冠状病毒肺炎（SARS-CoV-2）相关的多系统炎症综合征（MIS-C）患儿的肝脏和胰腺受累情况研究甚少。我们回顾了一组MIS-C患者，以分析急性肝损伤（ALI）和胰腺损伤的患病率及其与临床结局的相关性。前瞻性收集了MIS-C患儿入院时及住院期间的人口统计学、临床、实验室和影像学特征。纳入了55例患者（平均年龄6.5±3.7岁）。入院时，16例患者出现ALI，5例患者血清总脂肪酶升高。在观察期间，又有10例患者发生ALI，另有19例患者出现胰腺酶升高。与谷丙转氨酶（ALT）正常的患者相比，ALI患者年龄显著更大（P = 0.0004），而与胰腺酶正常的患者相比，胰腺受累与住院时间延长相关（P = 0.004）。入院至ALI发生的时间比胰腺酶升高的时间短（分别为3.2±3.9天和5.3±2.7天；P = 0.035）。腹部超声显示，26例ALI患者中有3例（12%）出现肝脂肪变性，6例（16%）出现肝肿大；2例患者胰腺肿大。虽然在MIS-C患者中常见肝脏和胰腺受累，但在大多数情况下症状较轻，可完全恢复。
