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儿童严重急性呼吸综合征冠状病毒 2 感染的并发症。

Complications of severe acute respiratory syndrome coronavirus 2 infection in children.

机构信息

Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini, Genoa.

UOSD Reumatologia e Immunologia Pediatrica, Ospedale Vito Fazzi, Lecce.

出版信息

Curr Opin Rheumatol. 2022 Sep 1;34(5):267-273. doi: 10.1097/BOR.0000000000000892. Epub 2022 Jul 5.

DOI:10.1097/BOR.0000000000000892
PMID:35797144
Abstract

PURPOSE OF REVIEW

Although during the initial stages of COVID-19 pandemic, the pediatric population seemed to be less affected, a number of SARS-CoV-2-related manifestations emerged over time, the principal of which is the multisystem inflammatory syndrome in children (MIS-C). Here we provide an update on the main pediatric disorders associated with SARS-CoV-2 infection.

RECENT FINDINGS

MIS-C is novel postinfectious manifestation with clinical features similar to Kawasaki disease and characterized by intense systemic inflammation affecting multiple organs. Many children required intensive care therapy because of circulatory shock, usually of myocardial origin. Appropriate treatment with immunomodulatory therapies led to favorable outcomes in most patients, with recovery of overall health and cardiac dysfunction. In addition to MIS-C, a variety of other complications of COVID-19 in children have been described, including thrombotic events, neurologic manifestations, and chilblain-like lesions. There is still uncertainty about the true prevalence of long COVID in children and its distinction from pandemic-related complaints.

SUMMARY

The experience gained so far with MIS-C and the other SARS-CoV-2-related complications in children and adolescents will facilitate accurate diagnosis and appropriate treatment. Further studies are needed to elucidate the pathophysiology of MIS-C and to determine the real impact of long-COVID in the pediatric age group.

摘要

目的综述

尽管在 COVID-19 大流行的初始阶段,儿科人群似乎受影响较小,但随着时间的推移,出现了许多与 SARS-CoV-2 相关的表现,其中主要是儿童多系统炎症综合征(MIS-C)。本文就与 SARS-CoV-2 感染相关的主要儿科疾病提供最新信息。

最近的发现

MIS-C 是一种新的感染后表现,其临床特征类似于川崎病,其特征是强烈的全身炎症影响多个器官。许多儿童因心肌来源的循环休克而需要重症监护治疗。大多数患者通过免疫调节治疗取得了良好的结果,整体健康和心功能得到恢复。除 MIS-C 外,还描述了儿童 COVID-19 的多种其他并发症,包括血栓事件、神经表现和冻疮样病变。关于儿童长 COVID 的真实流行率及其与大流行相关主诉的区别仍存在不确定性。

总结

迄今为止在儿童和青少年中获得的关于 MIS-C 和其他 SARS-CoV-2 相关并发症的经验将有助于准确诊断和适当治疗。需要进一步研究阐明 MIS-C 的病理生理学,并确定长 COVID 在儿科年龄组中的真正影响。

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