Menchaca-Aguayo Héctor, Alpizar-Rodriguez Deshire, Ramos-Tiñini Pamela, Faugier-Fuentes Enrique
Pediatric Rheumatology Department, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
Research Unit, Colegio Mexicano de Reumatología, Mexico City, Mexico.
Front Pediatr. 2022 Aug 12;10:949965. doi: 10.3389/fped.2022.949965. eCollection 2022.
To describe characteristics of patients with the pediatric inflammatory multisystem syndrome, temporally associated with SARS-CoV-2 (PIMS-TS)/multisystem inflammatory syndrome in children (MIS-C) and to identify factors associated with admission to the pediatric intensive care unit (PICU) in the Mexican children without coronavirus disease 2019 (COVID-19) vaccination.
This was a cross-sectional study performed at Hospital Infantil de Mexico Federico Gomez, a referral children's hospital in Mexico. The study included all cases that met the criteria for PIMS-TS/MIS-C, unvaccinated, between March 2020 and January 2022. The primary outcome was the admission to PICU. Associations of PICU admission with demographic and clinical variables were estimated using logistic regression analyses.
We identified a total of 90 cases, with a median age of 7.5 years old, 47 (52.2%) girls. A previously healthy status was recorded in 76 (85%) children. All patients had positive PCR, serology test, or COVID-19 exposure. PICU admission was reported in 41 (45.6%) children. No deaths were reported. Patients received as treatment only corticosteroids in 53.3% of the cases. In univariable analyses, baseline factors associated with PICU admission were older age, hypotension or shock, positive PCR test, hypoalbuminemia, elevated procalcitonin, ferritin, and lymphopenia. Age, shock at admission, and hypoalbuminemia remained independently associated in the multivariable analysis adjusted by gender and previously healthy status.
We found a high proportion of previously healthy children in patients with PIMS-TS/MIS-C in our center. Critical care attention was received by nearly half of the children. The main treatment used was steroids. Age, shock at admission, and hypoalbuminemia were factors associated with PICU admission.
描述与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）相关的儿童炎症性多系统综合征（PIMS-TS）/儿童多系统炎症综合征（MIS-C）患者的特征，并确定在未接种2019冠状病毒病（COVID-19）疫苗的墨西哥儿童中，与入住儿科重症监护病房（PICU）相关的因素。
这是一项在墨西哥转诊儿童医院墨西哥费德里科·戈麦斯儿童医院进行的横断面研究。该研究纳入了2020年3月至2022年1月期间所有符合PIMS-TS/MIS-C标准且未接种疫苗的病例。主要结局是入住PICU。使用逻辑回归分析估计入住PICU与人口统计学和临床变量之间的关联。
我们共确定了90例病例，中位年龄为7.5岁，47例（52.2%）为女孩。76例（85%）儿童既往健康状况良好。所有患者的新冠病毒聚合酶链反应（PCR）、血清学检测或COVID-19暴露均呈阳性。41例（45.6%）儿童报告入住PICU。未报告死亡病例。53.3%的病例中患者仅接受皮质类固醇治疗。在单变量分析中，与入住PICU相关的基线因素包括年龄较大、低血压或休克、PCR检测阳性、低白蛋白血症、降钙素原、铁蛋白升高和淋巴细胞减少。在按性别和既往健康状况调整的多变量分析中，年龄、入院时休克和低白蛋白血症仍然独立相关。
我们发现本中心PIMS-TS/MIS-C患者中既往健康儿童的比例很高。近一半的儿童接受了重症监护。主要使用的治疗方法是类固醇。年龄、入院时休克和低白蛋白血症是与入住PICU相关的因素。
