Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, Poland.
Department of Pediatric Cardiology and Rheumatology, Medical University of Lodz, Poland.
Int J Cardiol. 2022 Aug 15;361:126-133. doi: 10.1016/j.ijcard.2022.05.030. Epub 2022 May 14.
Background Pediatric multisystem inflammatory syndrome temporally associated with COVID-19 (PIMS-TS) is a serious complication of a previous SARS-CoV-2 infection in the group of pediatric patients. Despite the fact that this disease affects only about 1 of 1000 children, it may be severe, and changes in the cardiovascular system may cause long-term complications and the need for longitudinal patient care. Methods It is a single-center retrospective study considering 51 patients with PIMS-TS. The aim of this study was to analyze patients with PIMS-TS, taking into account demographic data, clinical course, laboratory tests and cardiovascular system assessment (electrocardiography, echocardiography, etc.). Results From June 2020 to October 2021, 51 patients with PIMS-TS were hospitalized in our center. In the studied group, 26/51 children (51%) were girls. The mean age of patients was 7 years. Changes in electrocardiograms were found in 21/51 patients. Echocardiography revealed pericardial fluid in most patients. In addition, heart valve insufficiency was found. Changes in the coronary vessels in the form of dilatations and even aneurysms were found in 42 patients. Myocardial hypokinesis was visualized in more than 1/4 of the patients. Sixteen patients (31.3%) required transfer to the intensive care unit (ICU) due to severe hypotension. Laboratory tests revealed increased levels of markers of heart failure and enzymes of myocardial damage. Conclusions Changes in the cardiovascular system in the course of PIMS-TS are of various nature, but in most patients they require close cardiac supervision and long-term follow-up.
背景 与 COVID-19 相关的儿童多系统炎症综合征（PIMS-TS）是儿科患者 SARS-CoV-2 感染前的一种严重并发症。尽管这种疾病仅影响大约千分之一的儿童，但它可能很严重，心血管系统的变化可能导致长期并发症和需要对患者进行纵向护理。
方法 这是一项单中心回顾性研究，共纳入 51 例 PIMS-TS 患者。本研究的目的是分析 PIMS-TS 患者，考虑人口统计学数据、临床病程、实验室检查和心血管系统评估（心电图、超声心动图等）。
结果 2020 年 6 月至 2021 年 10 月，我院共收治 51 例 PIMS-TS 患儿。在研究组中，26/51 例（51%）患儿为女性。患者的平均年龄为 7 岁。21/51 例患者出现心电图改变。超声心动图显示大多数患者有心包积液。此外，还发现心脏瓣膜功能不全。42 例患者冠状动脉出现扩张甚至动脉瘤样改变。超过 1/4 的患者存在心肌运动减弱。16 例（31.3%）患者因严重低血压需转入重症监护病房（ICU）。实验室检查显示心力衰竭标志物和心肌损伤酶水平升高。
结论 PIMS-TS 过程中心血管系统的改变性质多样，但大多数患者需要密切的心脏监护和长期随访。
