Meliț Lorena Elena, Mărginean Cristina Oana, Fleșeriu Tudor, Văsieșiu Anca Meda, Ghiga Dana Valentina, Koller Ana-Maria Roxana
Department of Pediatrics I, "George Emil Palade" University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No. 38, 540136 Târgu Mureș, Romania.
Department of Infectious Disease, County Clinical Hospital Târgu Mureș, Gheorghe Doja Street No. 89, 540394 Târgu Mureș, Romania.
Children (Basel). 2022 Sep 4;9(9):1348. doi: 10.3390/children9091348.
COVID-19 and PIMS represent two novel pathologies that have challenged the medical world during the last two years on account of their being very similar, but yet very different. Our aim was to comparatively assess children with SARS-CoV-2 infection and PIMS in terms of symptoms, clinical findings, laboratory parameters, echocardiography, and evolution. Our retrospective study included 46 children with COVID-19 (group 1), and 20 children with confirmed PIMS (group 2). We found no significant differences in terms of age, gender, and originating area between the two groups. We noticed that fever was significantly more common in the PIMS group as compared to COVID-19 group (p = 0.0217). In terms of laboratory parameters, increased bilirubin and creatinine were significantly more frequent in children with COVID-19 (p = 0.0064/p = 0.0064), while hypoalbuminemia and elevated ESR were significantly more common in those with PIMS (p < 0.0001/p = 0.0127). Moreover, prognosis parameters such as D-dimers, NT-proBNP, and CK-MB were also found to be significantly higher in the PIMS group as compared to COVID-19 group (p = 0.0003/p = 0.0182/p = 0.0007). In terms of complications, most were identified in PIMS group, among which cardiac and liver impairment along with dehydration were significantly more common in children diagnosed with PIMS as compared to those detected with COVID-19. Similarly, children with PIMS had a significantly higher chance to have pathological echocardiography changes. Although difficult, the distinction between COVID-19 and PIMS is crucial for the patient’s long-term outcome.
新冠病毒病（COVID-19）和儿童多系统炎症综合征（PIMS）是两种新型病症，在过去两年里给医学界带来了挑战，因为它们极为相似，但又截然不同。我们的目的是从症状、临床发现、实验室参数、超声心动图及病情发展等方面对感染严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的儿童和患PIMS的儿童进行比较评估。我们的回顾性研究纳入了46例新冠病毒病患儿（第1组）和20例确诊为PIMS的患儿（第2组）。我们发现两组在年龄、性别和来源地区方面无显著差异。我们注意到，与新冠病毒病组相比，发热在PIMS组更为常见（p = 0.0217）。在实验室参数方面，新冠病毒病患儿胆红素和肌酐升高更为频繁（p = 0.0064/p = 0.0064），而低蛋白血症和血沉升高在PIMS患儿中更为常见（p < 0.0001/p = 0.0127）。此外，与新冠病毒病组相比，PIMS组的D-二聚体、N末端B型利钠肽原（NT-proBNP）和肌酸激酶同工酶（CK-MB）等预后参数也显著更高（p = 0.0003/p = 0.0182/p = 0.0007）。在并发症方面，大多数并发症在PIMS组中被发现，与新冠病毒病患儿相比，确诊为PIMS的患儿出现心脏和肝脏损害以及脱水的情况更为常见。同样，PIMS患儿出现病理性超声心动图改变的几率显著更高。尽管困难，但区分COVID-19和PIMS对患者的长期预后至关重要。
