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拉丁美洲16个国家儿童多系统炎症综合征:来自REKAMLATINA网络的多中心研究

Multisystem inflammatory syndrome in children across 16 Latin American countries: A multicenter study from the REKAMLATINA Network.

作者信息

García-Silva Jimena, Ulloa-Gutierrez Rolando, Ivankovich-Escoto Gabriela, Yamazaki-Nakashimada Marco A, Faugier-Fuentes Enrique, Del Águila Olguita, Camacho-Moreno German, Estripeaut Dora, Gutiérrez Iván F, Castillo-Bustamante David, Luciani Kathia, Fabi Mariana, Espada Graciela, Álvarez-Olmos Martha I, Silfa Claribel, Pérez-Camacho Paola, Duarte-Passos Saulo, Cervi Maria C, Martínez-Ramírez Rogelio O, Cantillano Edwin M, Llamas-Guillén Beatriz A, Velásquez-Méndez Mónica, Saltigeral-Simental Patricia, Criales Javier, Fernández-Sarmiento Jaime, Chacon-Cruz Enrique, García-Domínguez Miguel, Aguilar Karla L Borjas, Villarreal-Treviño Ana V, Tremoulet Adriana H

机构信息

Facultad de Medicina, Universidad Autónoma de Nuevo León, Monterrey, México.

Servicio de Infectología Pediátrica, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Caja Costarricense de Seguro Social (CCSS), San José, Costa Rica.

出版信息

IJID Reg. 2024 Aug 3;12:100419. doi: 10.1016/j.ijregi.2024.100419. eCollection 2024 Sep.

Abstract

OBJECTIVES

Our aim was to describe the epidemiology and outcomes of multisystem inflammatory syndrome in children (MIS-C) in Latin America.

METHODS

We conducted an observational, retrospective, and prospective multicenter study that gathered information from 84 participating centers across 16 Latin American countries between August 1, 2020 and June 30, 2022.

RESULTS

Of the 1239 reported children with MIS-C, 84.18% were previously healthy. The most frequent clinical manifestation in our studied population was abdominal pain (N = 804, 64.9%), followed by conjunctival injection (N = 784, 63.3%). The median duration of fever at the time of hospital admission was 5 days and a significant number of subjects required admission to an intensive care unit (N = 589, 47.5%). Most of the subjects (N = 1096, 88.7%) were treated with intravenous immunoglobulin, whereas 76.7% (N = 947) were treated with steroids, of whom 10.6% (N = 100) did not receive intravenous immunoglobulin. The death rate attributed to MIS-C was 4.88%, with a rate of 3.39% for those initially diagnosed with MIS-C and 8.85% for those whose admission diagnosis was not MIS-C ( <0.001, odds ratio 2.76, 95% confidence interval 1.6-4.6).

CONCLUSIONS

One of the most significant findings from our study was the death rate, especially in those not initially diagnosed with MIS-C, in whom the rate was higher. This highlights the importance of increasing awareness and making an earlier diagnosis of MIS-C in Latin America.

摘要

目的

我们的目的是描述拉丁美洲儿童多系统炎症综合征(MIS-C)的流行病学和结局。

方法

我们开展了一项观察性、回顾性和前瞻性多中心研究,收集了2020年8月1日至2022年6月30日期间来自16个拉丁美洲国家84个参与中心的信息。

结果

在报告的1239例MIS-C患儿中,84.18%既往健康。我们研究人群中最常见的临床表现是腹痛(n = 804,64.9%),其次是结膜充血(n = 784,63.3%)。入院时发热的中位持续时间为5天,相当数量的受试者需要入住重症监护病房(n = 589,47.5%)。大多数受试者(n = 1096,88.7%)接受了静脉注射免疫球蛋白治疗,而76.7%(n = 947)接受了类固醇治疗,其中10.6%(n = 100)未接受静脉注射免疫球蛋白。MIS-C导致的死亡率为4.88%,最初诊断为MIS-C的患者死亡率为3.39%,入院诊断不是MIS-C的患者死亡率为8.85%(P<0.001,比值比2.76,95%置信区间1.6 - 4.6)。

结论

我们研究中最显著的发现之一是死亡率,尤其是在那些最初未被诊断为MIS-C的患者中,其死亡率更高。这凸显了在拉丁美洲提高对MIS-C的认识并进行早期诊断的重要性。

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