Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania.
Medicina (Kaunas). 2024 Oct 30;60(11):1774. doi: 10.3390/medicina60111774.
: Due to its link with the SARS-CoV-2, Multisystem Inflammatory Syndrome in Children (MIS-C) gained global attention as a serious condition that requires hospital care. Our study aimed to present the clinical and laboratory characteristics of MIS-C patients by age group and intensive care unit (ICU) admission status and assess early echocardiographic changes. : A single-center partly retrospective, partly prospective observational cohort study was performed from December 2020 to June 2024. The study included 42 patients aged between 1 month and 18 years who were diagnosed with MIS-C and gave informed consent. : The median age was 6.5 years (IQR 2.0-9.3). The predominant symptoms were cardiovascular (88.1%), mucocutaneous (85.7%) and gastrointestinal (76.2%). Five children (11.9%) developed shock. About two-thirds of patients (66.7%) were admitted to the ICU. Adolescents (≥12 years) were less likely to exhibit mucocutaneous or cardiovascular symptoms and thus less frequently having Kawasaki-like disease symptoms compared with other age groups (<5 years or 5-11 years). Lymphopenia was more common among patients aged 5 years and older. Adolescents had higher procalcitonin (PCT) and a lower estimated glomerular filtration rate. Troponin I and B-type natriuretic peptide (BNP) levels were higher in children aged 5-11 years, while ferritin levels were lower among the youngest (<5 years). Patients treated at the ICU were more likely to have cardiovascular and respiratory symptoms, as well as a history of symptomatic COVID-19, higher C-reactive protein (CRP), PCT, BNP and lower albumin levels. Echocardiographic abnormalities were found in 71.4% of cases. During hospitalization, left ventricular ejection fraction values increased significantly ( < 0.001) over 12 (IQR 9.0-14.0) days. : Symptoms and laboratory markers of MIS-C vary according to age. Higher CRP, PCT, BNP and hypoalbuminemia are predictors of MIS-C severity. Cardiovascular involvement is common and might be severe, but rapid resolution is encouraging.
由于与 SARS-CoV-2 的关联，儿童多系统炎症综合征 (MIS-C) 作为一种需要住院治疗的严重疾病引起了全球关注。我们的研究旨在按年龄组和重症监护病房 (ICU) 入院情况介绍 MIS-C 患者的临床和实验室特征，并评估早期超声心动图变化。
这项单中心部分回顾性、部分前瞻性观察队列研究于 2020 年 12 月至 2024 年 6 月进行。研究纳入了 42 名年龄在 1 个月至 18 岁之间、诊断为 MIS-C 并签署知情同意书的患者。
中位年龄为 6.5 岁（IQR 2.0-9.3）。主要症状为心血管（88.1%）、黏膜皮肤（85.7%）和胃肠道（76.2%）。5 名儿童（11.9%）发生休克。约三分之二的患者（66.7%）入住 ICU。青少年（≥12 岁）与其他年龄组（<5 岁或 5-11 岁）相比，黏膜皮肤或心血管症状较少，因此川崎病样症状较少。淋巴细胞减少在 5 岁及以上患者中更为常见。青少年降钙素原 (PCT) 较高，估算肾小球滤过率较低。肌钙蛋白 I 和 B 型利钠肽 (BNP) 水平在 5-11 岁儿童中较高，而铁蛋白水平在年龄最小的儿童（<5 岁）中较低。在 ICU 治疗的患者更有可能出现心血管和呼吸系统症状，以及有症状的 COVID-19 病史、更高的 C 反应蛋白 (CRP)、PCT、BNP 和较低的白蛋白水平。71.4%的病例存在超声心动图异常。住院期间，左心室射血分数值在 12（IQR 9.0-14.0）天内显著增加（<0.001）。
MIS-C 的症状和实验室标志物因年龄而异。较高的 CRP、PCT、BNP 和低白蛋白血症是 MIS-C 严重程度的预测指标。心血管受累常见且可能严重，但迅速缓解令人鼓舞。
