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新型冠状病毒肺炎相关儿童多系统炎症综合征的治疗进展

Update on the treatment of multisystem inflammatory syndrome in children associated with COVID-19.

作者信息

Long Fangyuan, Zhu Shiheng, Wang Zeguang, Zhang Shungeng, He Jinlong, Ge Xinbin, Ning Jun

机构信息

Department of Physiology, Jining Medical University, 133 Hehua Rd, Jining, 272067, China.

Department of Paediatrics, Affiliated Hospital of Jining Medical University, Jining, Shandong, 272029, China.

出版信息

Future Virol. 2022 Dec. doi: 10.2217/fvl-2022-0048. Epub 2023 Jan 19.

Abstract

In late 2019, SARS-CoV-2 was detected in China and spread worldwide. In rare cases, children who were infected with COVID-19 may develop multisystem inflammatory syndrome (MIS-C), which could have higher mortality than COVID-19 itself. Therefore, diagnosis and management are critical for treatment. Specifically, most of the initial treatment options of MIS-C choose intravenous immunoglobulin (IVIG) and steroids as the first-line treatment for patients. Moreover, antagonists of some cytokines are used as potential future therapeutics. Of note, therapeutic plasmapheresis can be used as a treatment for refractory severe MIS-C. We believe that each patient, especially those with comorbid conditions, should have individualized treatment based on both multidisciplinary consensus approach and expert opinion.

摘要

2019年末,在中国检测到严重急性呼吸综合征冠状病毒2(SARS-CoV-2)并在全球传播。在罕见情况下,感染新型冠状病毒肺炎(COVID-19)的儿童可能会发展为多系统炎症综合征(MIS-C),其死亡率可能高于COVID-19本身。因此,诊断和管理对治疗至关重要。具体而言,MIS-C的大多数初始治疗方案选择静脉注射免疫球蛋白(IVIG)和类固醇作为患者的一线治疗。此外,一些细胞因子拮抗剂被用作未来潜在的治疗方法。值得注意的是,治疗性血浆置换可用于治疗难治性重症MIS-C。我们认为,每位患者,尤其是患有合并症的患者,都应基于多学科共识方法和专家意见进行个体化治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4e1/9853872/f719922fced7/figure1.jpg

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