Vieira Ana Paula Radünz, Carvalho Paulo Roberto Antonaccio, Machado Sandra Helena, da Rocha Taís Sica
Pediatric Rheumatology Division, Federal University of Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street, 2350 - Santa Cecília, Porto Alegre City, Rio Grande do Sul, 90035-903, Brazil.
Pediatric Intensive Care Division, Federal University of Rio Grande do Sul, Hospital de Clínicas de Porto Alegre, Ramiro Barcelos Street, 2350 - Santa Cecília, Porto Alegre City, Rio Grande do Sul, 90035-903, Brazil.
Adv Rheumatol. 2025 Mar 17;65(1):16. doi: 10.1186/s42358-025-00447-6.
Numerous inflammatory complications related to COVID are described, including the Multisystem inflammatory Syndrome in Children (MIS-C) and Hyperinflammation. There is a scarcity of studies comparing these two groups.
Retrospective longitudinal outcome-conditioned study. Demographic, clinical, and laboratory variables are analyzed. Patients with history of COVID contact or infection with at least 24 h of fever, two or more systems involved and up to 21 years were included. Patients with no laboratory signal of inflammation or with other diagnoses for the condition were excluded. Demographic and laboratory data are presented as medians with interquartile ranges. Dichotomous variables and prevalences are reported as percentages. A ROC curve analysis was conducted to assess the discriminatory ability of these tests in relation to the MIS-C and hyperinflammation groups.
We present fifty-four patients, thirty-one with MIS-C and twenty-three with hyperinflammation. The most frequent symptom in the MIS-C group was altered mental status in 61% vs. 46% (p = 0.014) and conjunctival hyperemia in 29% vs. 4% (p = 0.032). The most frequent laboratory findings were hypoalbuminemia in 68% vs. 26% (p = 0.002), increased serum troponin in 42% vs. 26% (p = 0.034), increased d-dimers in 94% vs. 76% (p = 0.015), as well as increased BNP in 55% vs. 17% (p = 0.02). On the other hand, the hyperinflammation group more frequently presented respiratory dysfunction in 57% vs. 13% (p = < 0.001) and serum ferritin equal or greater than 500 ng/mL in 94% vs. 77% (p = 0.046).
This is an original study comparing clinical and laboratory findings between MIS-C and hyperinflammation due to COVID. Altered mental status is more frequently associated with MIS-C while respiratory symptoms are associated with hyperinflammation. In addition, regarding laboratory tests, there is hypoalbuminemia, increase in serum troponin, BNP, and D-dimers specially in the MIS-C group and hyperferritinemia in the hyperinflammation group. Further studies are needed to assess the cutoff point of biological markers such as BNP, troponin, and d-dimers for diagnosis and/or prognosis in the pediatric population with MIS-C.
已描述了许多与新冠病毒相关的炎症并发症，包括儿童多系统炎症综合征（MIS-C）和炎症风暴。比较这两组的研究较少。
回顾性纵向结局条件研究。分析人口统计学、临床和实验室变量。纳入有新冠病毒接触史或感染史、至少发热24小时、累及两个或更多系统且年龄在21岁以下的患者。排除无炎症实验室指标或有其他病症诊断的患者。人口统计学和实验室数据以中位数及四分位间距表示。二分变量和患病率以百分比报告。进行ROC曲线分析以评估这些检测对MIS-C组和炎症风暴组的鉴别能力。
我们纳入了54例患者，其中31例为MIS-C，23例为炎症风暴。MIS-C组最常见的症状是精神状态改变，占61%，而炎症风暴组为46%（p = 0.014）；结膜充血在MIS-C组为29%，炎症风暴组为4%（p = 0.
