Aikman Inga, Wright Brandon, Applegate Stacey, Whitfield Andrea, Alachraf Kamel, Sridhar Sruthipriya, Tumin Dmitry, Syed Salma
Division of Pediatric Critical Care and Hospital Medicine, East Carolina University Brody School of Medicine, Greenville, NC, USA; James and Connie Maynard Children's Hospital, Vidant Medical Center, Greenville, NC, USA; Department of Pediatrics, East Carolina University Brody School of Medicine, Greenville, NC, USA.
Department of Pediatrics, East Carolina University Brody School of Medicine, Greenville, NC, USA; Vidant Medical Center, Graduate Medical Education, Greenville, NC, USA.
Pediatr Neonatol. 2024 May;65(3):266-275. doi: 10.1016/j.pedneo.2023.05.011. Epub 2023 Oct 21.
The clinical features of Multisystem Inflammatory Syndrome in Children (MIS-C) have been well documented, but there is limited data regarding the short term and longitudinal outcomes of children living in rural areas. We report the demographic and clinical features, as well as the multi-specialty follow-up of patients with MIS-C served by a large tertiary care rural health system.
Patients that met the Centers for Disease Control (CDC) case definition of MIS-C admitted between March 1, 2020, and March 31, 2021, were included in this case series. Manual chart review was used to report demographic characteristics, clinical, laboratory and radiologic features during acute hospitalization and multispecialty follow-up, and adherence to follow-up 6-10 weeks after hospital discharge.
Twenty-one patients with MIS-C were admitted at our center during the review period. Ninety percent of the cohort required intensive care during hospitalization. Of 19 patients with measured ejection fractions, 52 % had some degree of left ventricular dysfunction on admission; nine patients had electrocardiogram changes on admission. The majority of patients had elevated inflammatory markers during hospitalization. Most patients had resolution of symptoms, improvement in inflammatory markers, and normal cardiac function at the time of discharge. Follow-up with pediatric cardiology, hematology-oncology and infectious disease was indicated for most patients at discharge. Of these, 100 % of patients kept initial follow-up appointments with pediatric cardiology and infectious disease, while 94 % kept initial follow-up appointments with pediatric hematology-oncology.
Though most patients were critically ill during hospitalization, the majority had resolution of cardiac abnormalities and inflammatory markers at discharge and timely follow-up with multiple subspecialists after admission with MIS-C.
儿童多系统炎症综合征（MIS-C）的临床特征已有充分记录，但关于农村地区儿童的短期和长期预后的数据有限。我们报告了由一个大型三级农村医疗保健系统服务的MIS-C患者的人口统计学和临床特征，以及多专科随访情况。
本病例系列纳入了2020年3月1日至2021年3月31日期间符合美国疾病控制中心（CDC）MIS-C病例定义的患者。通过人工查阅病历报告急性住院期间及多专科随访时的人口统计学特征、临床、实验室和放射学特征，以及出院后6 - 10周的随访依从性。
在研究期间，我们中心收治了21例MIS-C患者。该队列中90%的患者在住院期间需要重症监护。在19例测量了射血分数的患者中，52%在入院时存在一定程度的左心室功能障碍；9例患者入院时心电图有改变。大多数患者在住院期间炎症标志物升高。大多数患者在出院时症状缓解、炎症标志物改善且心功能正常。大多数患者出院时需要儿科心脏病学、血液肿瘤学和传染病学的随访。其中，100%的患者按时参加了儿科心脏病学和传染病学的首次随访预约，而94%的患者按时参加了儿科血液肿瘤学的首次随访预约。
尽管大多数患者在住院期间病情危重，但大多数患者在出院时心脏异常和炎症标志物得到缓解，并且在因MIS-C入院后及时接受了多个亚专科医生的随访。
