2021年9月29日至2022年6月21日期间因多系统炎症综合征（MIS-C）或新冠病毒病（COVID-19）住院儿童出院后的长期健康结局

Long-term Health Outcomes After Hospital Discharge Among Children Hospitalized for MIS-C or COVID-19, September 29, 2021, to June 21, 2022.

作者信息

Godfred-Cato Shana, Kunkel Amber, Abrams Joseph Y, Shah Ami B, Yousaf Anna, Hammett Teresa A, Choi Jong-Ha, Perez Maria A, Hsiao Hui-Mien, Rostad Christina A, Laham Federico R, Kao Carol M, Hunstad David A, Oster Matthew E, Campbell Angela P, Belay Ermias D

机构信息

COVID-19 Response Team, Centers for Disease Control and Prevention, Atlanta, Georgia.

Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia.

出版信息

Pediatr Infect Dis J. 2024 Nov 1;43(11):1074-1082. doi: 10.1097/INF.0000000000004477. Epub 2024 Aug 15.

DOI:10.1097/INF.0000000000004477

PMID:39163349

Abstract

BACKGROUND

The long-term effects of children hospitalized with multisystem inflammatory syndrome in children (MIS-C) or acute COVID-19 are not well known. Our objective was to determine long-term outcomes.

METHODS

Children hospitalized with MIS-C or COVID-19 at 3 US hospitals from March 2020, through February 2021 were followed to assess health through 2 years post-hospitalization using medical records and patient surveys.

RESULTS

Medical record abstraction was performed for 183 patients hospitalized with MIS-C, 53 of whom participated in surveys, and 97 patients hospitalized with COVID-19, 35 of whom participated in surveys. Patients with MIS-C were younger (median, 9 vs. 14 years of age for COVID-19 patients; P = 0.004), more frequently male (62% vs. 39%; P < 0.001) and had more cardiac (14% vs. 2%; P = 0.001) and neurologic sequelae (8% vs. 1%; P = 0.023). Children with COVID-19 more often had other comorbidities (59% vs. 19%; P < 0.001). Full mental recovery at the time of survey 2 (median, 16 months post-hospitalization for patients with MIS-C and 20 months for patients with COVID-19) was 85% and 88%, respectively; full physical recovery was 87% and 81%, respectively; and nearly all had resumption of normal activities. Patients with MIS-C reported more frequent headache at 1 month (45% vs. 20%; P = 0.037). Patients with COVID-19 were more likely to report cough at 1 month (37% vs. 17%; P = 0.045). Fatigue persisted >1 year in 15%-20% of patients in both groups.

CONCLUSIONS

Approximately 20% of children with MIS-C and COVID-19 continued to have symptoms including fatigue and headache >1 year after hospital discharge. The duration of these findings emphasizes the importance of providers following patients until sequelae have resolved.

摘要

背景

儿童多系统炎症综合征（MIS-C）或急性新冠病毒病（COVID-19）住院患儿的长期影响尚不清楚。我们的目的是确定长期预后情况。

方法

对2020年3月至2021年2月期间在美国3家医院因MIS-C或COVID-19住院的患儿进行随访，通过病历和患者调查评估出院后2年的健康状况。

结果

对183例因MIS-C住院的患者进行了病历摘要分析，其中53例参与了调查；对97例因COVID-19住院的患者进行了分析，其中35例参与了调查。MIS-C患者更年幼（中位数，MIS-C患者为9岁，COVID-19患者为14岁；P = 0.004），男性比例更高（62%对39%；P < 0.001），心脏后遗症（14%对2%；P = 0.001）和神经后遗症（8%对1%；P = 0.023）更多见。COVID-19患儿更常伴有其他合并症（59%对19%；P < 0.001）。在调查2时（MIS-C患者出院后中位数为16个月，COVID-19患者为20个月），完全精神恢复的比例分别为85%和88%；完全身体恢复的比例分别为87%和81%；几乎所有患儿都恢复了正常活动。MIS-C患者在1个月时头痛更频繁（45%对20%；P = 0.037）。COVID-19患者在1个月时更易出现咳嗽（37%对17%；P = 0.045）。两组中15%-20%的患者疲劳持续时间超过1年。