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儿童严重 COVID-19 的神经肌肉并发症:中期随访。

Neuromuscular complications of severe COVID-19 in paediatric patients: Medium-term follow-up.

机构信息

Unidad de Neurología Pediátrica, División de Pediatría, Escuela de Medicina, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Santiago, Región Metropolitana 8330077, Chile; Unidad de Neurología, Servicio de Pediatría, Complejo Asistencial Dr. Sótero del Río, Av. Concha y Toro 3459, Puente Alto, Región Metropolitana 8207257, Chile.

Unidad de Paciente Crítico Pediátrico, Servicio de Pediatría, Complejo Asistencial Dr. Sótero del Río, Av. Concha y Toro 3459, Puente Alto, Región Metropolitana 8207257, Chile.

出版信息

Neuromuscul Disord. 2022 Jun;32(6):486-492. doi: 10.1016/j.nmd.2022.04.001. Epub 2022 Apr 9.

Abstract

Neuromuscular complications in paediatric patients with severe coronavirus disease 2019 (COVID-19) are poorly characterised. However, adult patients with severe COVID-19 reportedly present with frequent neuromuscular complications that mainly include critical illness polyneuropathy (CIP), critical illness myopathy (CIM), and focal neuropathies. We examined the records of all paediatric patients with severe COVID-19 who were mechanically ventilated and experienced neuromuscular complications from our single tertiary centre between March 2020 and August 2021. During this period, 4/36 (11%) patients admitted to the paediatric ICU who were mechanically ventilated experienced neuromuscular complications (one CIM, two focal neuropathies, and one CIP associated with plexopathy). In three of them, the gamma genetic variant of SARS-CoV-2 was identified. At the 4-5 month follow-up, three of our patients exhibited slight clinical improvement. We conclude that paediatric patients with severe COVID-19 may present neuromuscular complications similar to adults (11%), and their medium-term prognosis seems unfavourable.

摘要

儿科 COVID-19 危重症患者的神经肌肉并发症特征描述较差。然而,据报道,重症 COVID-19 的成年患者常出现神经肌肉并发症,主要包括危重症多发性神经病(CIP)、危重症肌病(CIM)和局灶性神经病。我们对 2020 年 3 月至 2021 年 8 月期间在我们单一的三级中心因 COVID-19 而接受机械通气并出现神经肌肉并发症的所有儿科危重症 COVID-19 患者的记录进行了检查。在此期间,在机械通气的儿科 ICU 住院的 36 名患者中有 4 名(11%)出现了神经肌肉并发症(1 例 CIM、2 例局灶性神经病和 1 例与多发性神经病相关的 CIP)。其中 3 名患者的 SARS-CoV-2 存在 gamma 基因变异。在 4-5 个月的随访中,我们的 3 名患者表现出轻微的临床改善。我们的结论是,COVID-19 危重症的儿科患者可能会出现与成人相似的神经肌肉并发症(11%),且他们的中期预后似乎不佳。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b2af/8993496/1301151ef396/gr1_lrg.jpg

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