Pediatric Intensive Care Unit, Medanta - The Medicity, Sector 38, Gurugram, Haryana, 122001, India.
Neonatal and Pediatric Critical Care, Artemis Hospital, Gurugram, Haryana , India.
Indian J Pediatr. 2022 Oct;89(10):1040-1044. doi: 10.1007/s12098-022-04328-4. Epub 2022 Aug 27.
Multisystem inflammatory syndrome in children (MIS-C) occurs secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. A retrospective study, involving 6 tertiary-care centers in Haryana, was conducted to evaluate the clinical features, severity, laboratory findings, and outcomes of patients with MIS-C. Disease severity was graded (mild/moderate/severe) and presence of cardiac abnormalities noted. Patients with and without cardiac abnormalities and with and without severe disease were compared. Forty-eight children with MIS-C were included (median age - 9.5 y). Fever (100%), gastrointestinal (83.3%) and mucocutaneous (50%) symptoms were common. Only 16.7% patients had previous history of documented SARS-CoV-2 infection/contact. Severe disease and cardiac abnormalities were seen in 47.9% and 54.2% patients, respectively. NT-proBNP > 1286.5 pg/mL and thrombocytopenia (≤ 119500/µL) were significant risk factors for severe MIS-C. Forty-five patients (93.8%) recovered and 3 died. Median hospitalization duration was 7 d (5-9.5). MIS-C must be considered as a possibility in any febrile child, even if a positive epidemiological history is absent. High NT-proBNP and thrombocytopenia are significant risk factors for severe MIS-C. (Trial Registration: The study was registered with the Clinical Trials Registry, India (CTRI/2021/09/036491)).
儿童多系统炎症综合征（MIS-C）继发于严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染。在哈里亚纳邦的 3 家 3 级保健中心进行了一项回顾性研究，以评估 MIS-C 患者的临床特征、严重程度、实验室发现和结局。对疾病严重程度进行分级（轻度/中度/重度）并记录心脏异常情况。比较了有和无心脏异常以及有和无重度疾病的患者。共纳入 48 例 MIS-C 患儿（中位数年龄为 9.5 岁）。发热（100%）、胃肠道（83.3%）和黏膜皮肤（50%）症状常见。仅有 16.7%的患者有既往确诊 SARS-CoV-2 感染/接触史。重度疾病和心脏异常分别见于 47.9%和 54.2%的患者。NT-proBNP>>1286.5pg/mL 和血小板减少症（≤119500/µL）是重度 MIS-C 的显著危险因素。45 例（93.8%）患者康复，3 例死亡。中位住院时间为 7 天（5-9.5 天）。即使无阳性的流行病学史，任何发热的儿童都应考虑 MIS-C 的可能性。高 NT-proBNP 和血小板减少症是重度 MIS-C 的显著危险因素。（试验注册：该研究在印度临床试验注册中心（CTRI/2021/09/036491）进行了注册）。
