Instituto Nacional de Salud del Niño-Breña, Lima, Perú.
Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Perú.
Rev Peru Med Exp Salud Publica. 2024 Oct 21;41(3):301-308. doi: 10.17843/rpmesp.2024.413.13736.
Motivation for the study. There are few studies describing the variation of COVID-19-associated multisystem inflammatory syndrome (MIS-C) in Peru across pandemic waves.
Main findings. Cases of MIS-C decreased during the first three years of the pandemic, with higher frequency in the second wave with clinical features similar to Kawasaki disease.
Implications. MIS-C is a post-infectious complication of SARS-CoV-2. Its diagnostic suspicion is important weeks after peak infections, especially in children who have not yet received COVID-19 vaccines.
This study aimed to describe the characteristics of multisystemic inflammatory syndrome associated with COVID-19 (MIS-C) in the first three years of the pandemic in children in a pediatric hospital in Peru. We conducted an observational, descriptive study with data from 73 patients and described the clinical and laboratory characteristics, treatment and complications according to the wave of the pandemic and whether they had shock. The median age was 6 years, gastrointestinal and mucocutaneous manifestations were frequent in the three waves. Kawasaki disease-like phenotype was present in 34 (46.6%) patients and 21 (28.8%) patients developed shock. The most commonly used treatment was immunoglobulin (95.9%), followed by acetylsalicylic acid (94.5%) and corticosteroid (86.3%). Five (7%) patients had coronary aneurysm and 17 (23.3%) were admitted to the intensive care unit (ICU). Patients with shock had greater laboratorial alteration and need for mechanical ventilation. In conclusion, MIS-C has decreased in the first three years of the pandemic, possibly due to COVID-19 vaccination in children.
研究动机。鲜有研究描述秘鲁在各波次大流行期间与 COVID-19 相关的儿童多系统炎症综合征（MIS-C）的变化情况。
主要发现。MIS-C 病例在大流行的头三年减少，在第二波次中发病率更高，具有与川崎病相似的临床特征。
意义。MIS-C 是 SARS-CoV-2 感染后的一种并发症。在感染高峰数周后，尤其是在尚未接种 COVID-19 疫苗的儿童中，对其进行诊断性怀疑很重要。
本研究旨在描述秘鲁一家儿科医院在大流行的头三年中 COVID-19 相关多系统炎症综合征（MIS-C）患儿的特征。我们进行了一项观察性、描述性研究，共纳入 73 例患者的数据，根据大流行波次和是否存在休克描述了临床和实验室特征、治疗方法和并发症。中位年龄为 6 岁，3 个波次中均以胃肠道和黏膜皮肤表现多见。34 例（46.6%）患者存在川崎病样表型，21 例（28.8%）患者发生休克。最常使用的治疗方法是免疫球蛋白（95.9%），其次是乙酰水杨酸（94.5%）和皮质类固醇（86.3%）。5 例（7%）患者存在冠状动脉瘤，17 例（23.3%）患者入住重症监护病房（ICU）。发生休克的患者实验室检查改变更明显，需要机械通气。总之，MIS-C 在大流行的前三年有所减少，这可能是由于儿童接种了 COVID-19 疫苗。
