Paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 mimicking Kawasaki disease (Kawa-COVID-19): a multicentre cohort
Paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 mimicking Kawasaki disease (Kawa-COVID-19): a multicentre cohort
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DOI：
10.1136/annrheumdis-2020-217960
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发表时间：
2020-08-01
影响因子：
27.4
通讯作者：
Melki, Isabelle
中科院分区：
文献类型：
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作者：
Pouletty, Marie;Borocco, Charlotte;Melki, Isabelle
背景目前的数据表明，新冠肺炎在儿童中较少发生，病程较轻。然而，在过去的几周里，在大巴黎地区的医院里，越来越多的儿童出现了类似川崎病(KD)的表型，这引起了法国国家卫生当局的警报。方法多中心汇编了自2020年4月以来巴黎地区与检测到严重急性呼吸综合征冠状病毒2型(‘Kawa-新冠肺炎’)相关的KD患者。结果纳入16例患者，性别比为1，智商中位数为10岁(4.7~12.5)。12例(69%)检测到SARS-CoV-2，另有3例记录了最近与定量聚合酶链式反应阳性的个人接触(19%)。心脏受累包括心肌炎占44%(n=7)。严重疾病(即需要重症监护，n=7)的预后因素为年龄>5岁和高铁血症(1400µg/L)，仅5例(31%)患者一次静脉注射免疫球蛋白(IVIg)成功，10例(62%)需要二线治疗。卡瓦-新冠肺炎队列在发病时10岁与2岁时与‘经典’KD对照组相比年龄更大(p
Background Current data suggest that COVID-19 is less frequent in children, with a milder course. However, over the past weeks, an increase in the number of children presenting to hospitals in the greater Paris region with a phenotype resembling Kawasaki disease (KD) has led to an alert by the French national health authorities.Methods Multicentre compilation of patients with KD in Paris region since April 2020, associated with the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ('Kawa-COVID-19'). A historical cohort of 'classical' KD served as a comparator.Results Sixteen patients were included (sex ratio=1, median age 10 years IQR (4.7 to 12.5)). SARS-CoV-2 was detected in 12 cases (69%), while a further three cases had documented recent contact with a quantitative PCR-positive individual (19%). Cardiac involvement included myocarditis in 44% (n=7). Factors prognostic for the development of severe disease (ie, requiring intensive care, n=7) were age over 5 years and ferritinaemia >1400 mu g/L. Only five patients (31%) were successfully treated with a single intravenous immunoglobulin (IVIg) infusion, while 10 patients (62%) required a second line of treatment. The Kawa-COVID-19 cohort differed from a comparator group of 'classical' KD by older age at onset 10 vs 2 years (p