Division of Rheumatology, The Children's Hospital at Montefiore, 3334 Bainbridge Avenue, Bronx, NY, 10467, USA.
Albert Einstein College of Medicine, Bronx, NY, USA.
Pediatr Rheumatol Online J. 2023 Aug 11;21(1):82. doi: 10.1186/s12969-023-00861-4.
Growing evidence suggests that infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may trigger idiopathic inflammatory myopathies (IIM). Few studies have described individual juvenile IIM (JIIM) cases following SARS-CoV-2 infection, and none explored its potential effects on JIIM clinical presentation. We aim to investigate the impact of SARS-CoV-2 on JIIM in patients diagnosed before and after the onset of the Coronavirus Disease 2019 (COVID-19) pandemic.
Patients diagnosed with JIIM before age 19 at The Children's Hospital at Montefiore were included. Demographics, clinical and laboratory data, and evidence of SARS-CoV-2 exposure were collected retrospectively. Patients were grouped by pre-COVID-19 (before January 1, 2020) and post-COVID-19 (January 1, 2020, or later). Descriptive statistics were used to summarize each variable. Non-parametric testing was performed using Fischer's exact test and Mann-Whitney U test.
Fifty-one patients were included, 13 (25%) diagnosed in the post-COVID-19 era. Of these, 10 (77%) had onset of JIIM symptoms after January 1, 2020; 6 (60%) with known or suspected SARS-CoV-2 exposure. Though not statistically significant, post-pandemic patients tended to be older, female, and have non-specific cutaneous manifestations. Despite reported delays in care for other pediatric diagnoses during the pandemic, fewer post-pandemic patients had delays in JIIM diagnosis.
This is the first study to explore the effects of SARS-CoV-2 on JIIM clinical presentation. While our exploratory single-center study did not find significant differences in JIIM diagnosed pre- and post-pandemic, larger prospective multicenter studies are warranted to evaluate this association and to explore clinical variances over time.
越来越多的证据表明，严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）感染可能引发特发性炎症性肌病（IIM）。少数研究描述了 SARS-CoV-2 感染后个别青少年特发性肌炎（JIIM）病例，尚无研究探讨其对 JIIM 临床表现的潜在影响。我们旨在调查 SARS-CoV-2 对 COVID-19 大流行前后诊断的 JIIM 患者的影响。
纳入在 Montefiore 儿童医院被诊断为 JIIM 的年龄在 19 岁以下的患者。回顾性收集人口统计学、临床和实验室数据以及 SARS-CoV-2 暴露证据。患者按 COVID-19 前（2020 年 1 月 1 日之前）和 COVID-19 后（2020 年 1 月 1 日或之后）分组。使用描述性统计来总结每个变量。使用 Fisher 精确检验和 Mann-Whitney U 检验进行非参数检验。
共纳入 51 例患者，其中 13 例（25%）在 COVID-19 后被诊断。其中，10 例（77%）在 2020 年 1 月 1 日后出现 JIIM 症状；6 例（60%）有已知或疑似 SARS-CoV-2 暴露。尽管没有统计学意义，但 COVID-19 后患者年龄较大、女性比例较高且有非特异性皮肤表现。尽管大流行期间其他儿科疾病的治疗存在延迟，但 COVID-19 后患者 JIIM 诊断的延迟较少。
这是第一项探讨 SARS-CoV-2 对 JIIM 临床表现影响的研究。虽然我们的探索性单中心研究未发现 COVID-19 前后诊断的 JIIM 之间存在显著差异，但需要更大规模的前瞻性多中心研究来评估这种关联，并探讨随时间推移的临床差异。
