AboAlEla Habiba H, Ali Abdulrahman Y, Al-Sharif Ghadah A, Abuhammour Walid, Tayoun Ahmad Abou, Almoosa Mohammad, Uribe Diego Arango, Al-Fraihat Ali, Ho Samuel B, Khamis Amar H, Popatia Rizwana, Yavuz Lemis
College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates.
Pediatr Pulmonol. 2023 Oct;58(10):2930-2940. doi: 10.1002/ppul.26614. Epub 2023 Aug 10.
Multisystem inflammatory syndrome in children (MISC) is a phenomenon that appeared in children infected with or exposed to severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). The typical onset of MISC is 4-6 weeks following SARS-CoV-2 infection and is formulated to be due to an immune response.
Our study retrospectively analyzed data from a tertiary center in United Arab Emirates of MISC patients who were admitted to either general pediatric wards or pediatric intensive care (PICU) or who came exclusively for follow-up (post-PICU admission) from May 2020 to August 2021.
The total sample size was 50 patients, and the study included a comparison of MISC-PICU admissions with MISC-non-PICU admissions. The MISC-PICU sample size was 18 patients, 50% females, with mean age of 8.3 years all were previously healthy. MISC-PICU patients had deranged blood counts with a lower hemoglobin count, a more pronounced lymphopenia and thrombocytopenia along with hypoalbuminemia. MISC-PICU patients presented with relatively higher inflammatory markers: C-reactive protein, procalcitonin, ferritin, and d-dimer. Immunological studies were significantly higher for interleukin-6 levels in PICU patients. On echocardiography, higher myocardial dysfunction was more notable in MISC-PICU patients. Likewise, MISC-PICU patients were provided with more extensive therapy. As part of our study course, we reevaluated our MISC-PICU patients twice, once at 48 h post-PICU admission and again 4-6 weeks after discharge from the hospital. No deaths have been recorded in the cohort.
This study evaluated risk factors of MISC and potential severity features. Follow-up of patients on discharge showed improvement across all domains.
儿童多系统炎症综合征（MISC）是一种出现在感染或接触严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的儿童中的现象。MISC的典型发病时间是在SARS-CoV-2感染后的4至6周，其发病机制被认为是免疫反应所致。
我们的研究回顾性分析了2020年5月至2021年8月期间在阿拉伯联合酋长国一家三级中心收治的MISC患者的数据，这些患者被收治于普通儿科病房或儿科重症监护室（PICU），或者仅前来进行随访（PICU出院后）。
总样本量为50例患者，该研究对MISC-PICU入院患者与MISC-非PICU入院患者进行了比较。MISC-PICU样本量为18例患者，其中50%为女性，平均年龄8.3岁，所有患者此前均健康。MISC-PICU患者的血常规出现紊乱，血红蛋白计数降低，淋巴细胞减少和血小板减少更为明显，同时伴有低白蛋白血症。MISC-PICU患者的炎症标志物水平相对较高：C反应蛋白、降钙素原、铁蛋白和D-二聚体。PICU患者的白细胞介素-6水平的免疫学研究结果显著更高。在超声心动图检查中，MISC-PICU患者的心肌功能障碍更为明显。同样，MISC-PICU患者接受了更广泛的治疗。作为我们研究过程的一部分，我们对MISC-PICU患者进行了两次重新评估，一次是在PICU入院后48小时，另一次是在出院后4至6周。该队列中未记录到死亡病例。
本研究评估了MISC的危险因素和潜在的严重程度特征。患者出院后的随访显示所有方面均有改善。
