Cardiac Abnormalities Seen in Pediatric Patients During the SARS-CoV2 Pandemic: An International Experience.
Cardiac Abnormalities Seen in Pediatric Patients During the SARS-CoV2 Pandemic: An International Experience.
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DOI：
10.1161/jaha.120.018007
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发表时间：
2020-11-03
影响因子：
5.4
通讯作者：
Chowdhury D
中科院分区：
文献类型：
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作者：
Clark BC;Sanchez-de-Toledo J;Bautista-Rodriguez C;Choueiter N;Lara D;Kang H;Mohsin S;Fraisse A;Cesar S;Sattar Shaikh A;Escobar-Diaz MC;Hsu DT;Randanne PC;Aslam N;Kleinmahon J;Lamour JM;Johnson JN;Sarquella-Brugada G;Chowdhury D
在 SARS-CoV2 大流行期间，先前健康且具有多种心脏表现的儿童的过度炎症表现有所增加。我们的目标是描述 SARS-CoV2 大流行期间 55 例多系统炎症综合征 (MIS-C) 儿科病例的国际队列中发现的心脏表现。我们回顾了之前健康、心脏结构正常的儿科患者（≤18 岁）的数据，这些患者在美国、英国、西班牙和巴基斯坦的医院就诊，患有 MIS-C，并咨询了儿科心脏病专家。收集的数据包括人口统计、临床表现、实验室值、心电图异常、超声心动图结果和初始治疗。共有 55 名患者出现 MIS-C。 35 名患者（64%）有左心室功能下降的证据，17 名患者（31%）有瓣膜炎，12 名患者（22%）有心包积液，11 名患者（20%）有冠状动脉异常。 27 人 (49%) 需要入住 ICU，24 人 (44%) 有休克证据。 11 名患者 (20%) 完全符合川崎病标准，与不符合标准的患者相比，NT pro-BNP、D-二聚体和铁蛋白水平较低。 6 名患者出现电生理异常，包括完全性房室传导阻滞、短暂性房室传导阻滞和室性心动过速。我们描述了 SARS-CoV2 大流行期间首个国际 MIS-C 儿科患者队列，这些患者具有一系列心脏表现。本文提高了全球医学界的认识和警觉性，以在大流行期间识别这些儿童，并了解早期心脏病学评估和随访的必要性。
During the SARS‐CoV2 pandemic, there has been increase in hyperinflammatory presentation in previously healthy children with a variety of cardiac manifestations. Our objective is to describe the cardiac manifestations found in an international cohort of 55 pediatric cases with multi‐system inflammatory syndrome (MIS‐C) during the SARS‐CoV2 pandemic. We reviewed data on previously healthy pediatric patients (≤18 years) with structurally normal hearts who presented at hospitals in the United States, United Kingdom, Spain and Pakistan with MIS‐C and had consultation with a pediatric cardiologist. Data collected included demographics, clinical presentation, laboratory values, electrocardiographic abnormalities, echocardiographic findings and initial therapies. A total of 55 patients presented with MIS‐C. Thirty‐five patients (64%) had evidence of decreased left ventricular function, 17 (31%) had valvulitis, 12 (22%) with pericardial effusion and 11 (20%) with coronary abnormalities. Twenty‐seven (49%) required ICU admission and 24 (44%) had evidence of shock. Eleven patients (20%) fulfilled complete Kawasaki disease criteria and had lower NT pro‐BNP, D‐dimer and ferritin levels compared with those who did not fulfill criteria. Electrophysiologic abnormalities occurred in 6 patients and included complete atrioventricular (AV) block, transient AV block and ventricular tachycardia. We describe the first international cohort of pediatric patients with MIS‐C during the SARS‐CoV2 pandemic with a range of cardiac manifestations. This paper brings awareness and alertness to the global medical community to recognize these children during the pandemic and understand the need for early cardiology evaluation and follow‐up.