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及时解决儿童与 SARS-CoV-2 相关的多系统炎症综合征。

Timely Resolution of SARS-CoV-2-Related Multi-System Inflammatory Syndrome in Children.

机构信息

Division of Rheumatology, Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL 35233-1711, USA.

Children's of Alabama, Division of Rheumatology, 1600 7th Ave. S., Birmingham, AL 35233-1711, USA.

出版信息

Viruses. 2022 Dec 29;15(1):94. doi: 10.3390/v15010094.

Abstract

: Multisystem inflammatory syndrome in children (MIS-C) is a severe, postinfectious manifestation of coronavirus disease 2019 (COVID-19) in the pediatric population. The disease is manifested by hyperinflammation and can result in cardiac dysfunction, coronary changes, and end-organ damage. Adequate timely treatment can prevent poor outcomes in the short term, but long-term data is lacking. : A large single center MIS-C cohort was followed longitudinally after treatment with intravenous immunoglobulin (IVIG) ± glucocorticoids to determine the natural history of the disease and to describe improvement in laboratory markers and cardiac outcomes. Patient were stratified by disease severity and compared. : 137 patients were identified with demographics similar to previously described cohorts. Regardless of disease severity, when adequately treated, initial lab abnormalities rapidly improved by the 6-8 month follow-up period, with some resolved in as little as 1-2 weeks. Similarly, cardiac abnormalities improved quickly after treatment; all abnormalities resolved in this cohort by 1-2 months post-hospitalization. : Although MIS-C is a serious sequela of COVID-19, when identified quickly and treated aggressively, laboratory abnormalities, coronary dilatation, and systolic dysfunction rapidly improve with minimal long-term morbidity or mortality.

摘要

儿童多系统炎症综合征(MIS-C)是儿童感染 2019 年冠状病毒病(COVID-19)后的一种严重的感染后表现。该疾病表现为炎症过度活跃,可导致心功能障碍、冠状动脉变化和终末器官损伤。及时进行充分治疗可以预防短期不良预后,但缺乏长期数据。

一个大型的单中心 MIS-C 队列在接受静脉注射免疫球蛋白(IVIG)±糖皮质激素治疗后进行了纵向随访,以确定疾病的自然病程,并描述实验室标志物和心脏结局的改善情况。患者根据疾病严重程度进行分层并进行比较。

研究共确定了 137 例具有与先前描述的队列相似特征的患者。无论疾病严重程度如何,在得到充分治疗后,最初的实验室异常在 6-8 个月的随访期间迅速改善,一些异常在 1-2 周内得到解决。同样,心脏异常在治疗后迅速改善;本队列中所有异常在住院后 1-2 个月内均得到解决。

尽管 MIS-C 是 COVID-19 的严重后遗症,但如果能迅速发现并积极治疗,实验室异常、冠状动脉扩张和收缩功能障碍会迅速改善,长期发病率和死亡率很低。

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本文引用的文献

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Who Would Have Predicted Multisystem Inflammatory Syndrome in Children?
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Longitudinal Outcomes for Multisystem Inflammatory Syndrome in Children.
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