Department of Pediatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam; Children's Hospital 1, Ho Chi Minh City, Viet Nam.
Department of Pediatrics, University of Medicine and Pharmacy at Ho Chi Minh City, Viet Nam; Children's Hospital 1, Ho Chi Minh City, Viet Nam.
Pediatr Neonatol. 2022 Nov;63(6):569-574. doi: 10.1016/j.pedneo.2022.05.009. Epub 2022 Jul 8.
This study aimed to describe the cardiovascular injury and clinical features of multisystem inflammatory syndrome in children (MIS-C) related to coronavirus disease 2019 (COVID-19) in Ho Chi Minh City, Vietnam.
This was a retrospective cohort study of children with MIS-C (from September 1, 2021 to February 28, 2022) in Children's Hospital 1, Ho Chi Minh City. Demographics, clinical history, significant underlying conditions, clinical manifestations, laboratory investigations, and medical management were analyzed.
A total of 76 patients were included (median age, 5.9 years old, 2 months-16 years). The male/female ratio was 1.6/1. Most patients (75/76) had no previous medical conditions. The mean time from acute severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to symptom onset was 39 days. During an acute SARS-CoV-2 infection, these patients are either asymptomatic or mildly symptomatic. In addition to fever, gastrointestinal symptoms were also prominent, as observed in our study, with 75%, 73.7%, and 72.3% of patients presenting with abdominal pain, vomiting, and loose stools, respectively. The levels of inflammatory markers increased upon admission and returned to normal levels after treatment. Echocardiography revealed decreased myocardial contractility and coronary injury in 16 (21.1%) and 32 (42.1%) patients, respectively. Most cases (72/76) had no fever within 3 days of intravenous immunoglobulin (IVIG) and methylprednisolone treatment. No deaths occurred in this study. The mean duration of hospitalization was 7.2 days.
Cardiovascular involvement was observed in approximately 53.9% of the patients. Anti-inflammatory treatment with IVIG and methylprednisolone had a favorable short-term outcome. However, long-term follow-up studies on post-discharge MIS-C cases are needed to make appropriate treatment recommendations in the acute phase.
本研究旨在描述越南胡志明市与 2019 年冠状病毒病（COVID-19）相关的儿童多系统炎症综合征（MIS-C）的心血管损伤和临床特征。
这是一项回顾性队列研究，纳入了胡志明市儿童医院 1 号的 MIS-C 患儿（2021 年 9 月 1 日至 2022 年 2 月 28 日）。分析了人口统计学、临床病史、重要的基础疾病、临床表现、实验室检查和医疗管理。
共纳入 76 例患儿（中位年龄为 5.9 岁，2 个月至 16 岁）。男女比例为 1.6/1。大多数患者（75/76）无既往病史。从急性严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染到症状发作的平均时间为 39 天。在急性 SARS-CoV-2 感染期间，这些患者无症状或症状轻微。除发热外，胃肠道症状也很突出，在本研究中，75%、73.7%和 72.3%的患者分别有腹痛、呕吐和腹泻。入院时炎症标志物水平升高，治疗后恢复正常。超声心动图显示 16（21.1%）和 32（42.1%）例患者心肌收缩力下降和冠状动脉损伤。大多数病例（72/76）在静脉注射免疫球蛋白（IVIG）和甲基强的松龙治疗后 3 天内无发热。本研究无死亡病例。平均住院时间为 7.2 天。
约 53.9%的患者存在心血管受累。IVIG 和甲基强的松龙的抗炎治疗具有良好的短期疗效。然而，需要对出院后 MIS-C 病例进行长期随访研究，以便在急性期提出适当的治疗建议。
