Pediatric multisystem SARS COV2 with versus without cardiac involvement: a multicenter study from Latin America.
Pediatric multisystem SARS COV2 with versus without cardiac involvement: a multicenter study from Latin America.
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儿科多系统SARS COV2伴与不伴心脏受累：一项来自拉丁美洲的多中心研究
DOI：
10.1007/s00431-021-04052-9
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发表时间：
2021-09
影响因子：
3.6
通讯作者：
Zachariah JP
中科院分区：
文献类型：
--
作者：
Pignatelli R;Antona CV;Rivera IR;Zenteno PA;Acosta YT;Huertas-Quiñones M;Murillo CA;Torres FM;Cabalin CF;Camacho AG;Pérez AA;Lombardi AB;Soares AM;Garcia CT;Borges CT;Villalba CN;Lechado CR;Dias DT;Morales DA;Copete EM;Goldenberg GL;Salazar JS;Moreira JA;Asakura J;Sabando KS;Branco KC;Rosas LT;Duarte MP;Carbajal MJ;Hernandez MR;Martínez MM;Echeverría NG;Caneva OM;Sepulveda PR;Díaz PA;Plúas RR;Alvarado TC;Faundes LT;Diaz YB;Zachariah JP
拉丁美洲(LATAM)儿童对严重急性呼吸综合征冠状病毒2(SARS COV2)有特别的洞察力，这是由于高风险的种族/民族、医疗资源的多变性、不同的社会经济背景以及许多涉及的器官系统。这项对LATAM青年进行的多国研究检查了急性或晚期多系统SARS COV2有心脏受累和没有心脏受累的特征。在参加儿童心脏多成像学会的10个拉丁美洲国家的32个中心的0-18岁青年(N=98；50%男性)中，连续样本表现为多系统SARS COV2，分组为有心脏受累和无心脏受累，定义为异常超声心动图表现或心律失常。收集的临床资料采用t检验或Fisher精确检验进行统计分析。有心脏(N=48，50%男性)和无心脏(N=50，50%男性)在年龄、体重、非呼吸系统症状和病史方面相似。心脏组有1例死亡，症状包括冠状动脉扩张、射血分数及50%、心包积液、外周水肿、心律失常和肺动脉血栓。心脏病组的风险较高(77%比54%，p=0.02)；有创机械(23%比4%，p=0.007)；血管活性输液(27%比4%，p=0.002)；明显的呼吸道症状(60%比36%，p=0.03)；胸部影像异常(69%比34%，p=0.001)；肌钙蛋白(33%比12%，p=0.001)；丙氨酸转氨酶(33%比12%，p=0.02)；血小板减少(46%比22%，P=0.02)。受试者操作曲线分析显示，异常实验室对是否需要ICU干预的敏感性为94%，阴性预测值为98%。结论：LATAM患儿合并多系统SARS-COV2时，心脏受累较多。心脏受累更可能需要ICU干预、某些异常实验室和呼吸受累。网上版载有补充材料，可在10.1007/s00431-021-04052-9查阅。
Latin America (LATAM) children offer special insight into Severe Acute Respiratory Syndrome Coronavirus 2 (SARS COV2) due to high-risk race/ethnicity, variability in medical resources, diverse socioeconomic background, and numerous involved organ systems. This multinational study of LATAM youth examined the distinguishing features of acute or late multisystem SARS COV2 with versus without cardiac involvement. A consecutive sample of youth 0–18 years old (N = 98;50% male) presenting with multisystem SARS COV2 to 32 centers in 10 Latin American countries participating in a pediatric cardiac multi-imaging society were grouped as with versus without cardiac involvement, defined as abnormal echocardiographic findings or arrhythmia. Collected clinical data were analyzed by Student’s t-test or Fisher’s exact test. Cardiac (N = 48, 50% male) versus no cardiac (N = 50, 50% male) were similar in age; weight; nonrespiratory symptoms; and medical history. The cardiac group had 1 death and symptoms including coronary artery dilation, ejection fraction <50%, pericardial effusion, peripheral edema, arrhythmia, and pulmonary artery thrombus. The cardiac group had higher risk of ICU admission (77% vs 54%, p = 0.02); invasive ventilation (23% vs 4%,p = 0.007); vasoactive infusions (27% vs 4%, p = 0.002); prominent respiratory symptoms (60% vs 36%, p < 0.03); abnormal chest imaging (69% vs 34%, p = 0.001); troponin (33% vs 12%, p = 0.01); alanine aminotransferase (33% vs 12%, p = 0.02); and thrombocytopenia (46% vs 22%, p = 0.02). Receiver operating curve analysis showed that abnormal laboratories had 94% sensitivity and 98% negative predictive value on the need for ICU interventions. Conclusion: In LATAM children with multisystem SARS COV2, cardiac involvement was prevalent. Cardiac involvement was more likely to require ICU interventions, certain abnormal labs, and respiratory involvement. The online version contains supplementary material available at 10.1007/s00431-021-04052-9.
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DOI：
10.1001/jama.2020.6775
发表时间：
2020-01-01
期刊：
JAMA, Journal of the American Medical Association
影响因子：
--
作者：
Richardson, Safiya;Hirsch, Jamie S.;,
通讯作者：
,
影响因子：
3.9
作者：
Raharja A;Tamara A;Kok LT
通讯作者：
Kok LT
影响因子：
158.5
作者：
Dufort, Elizabeth M.;Koumans, Emilia H.;Zucker, Howard
通讯作者：
Zucker, Howard
影响因子：
158.5
作者：
Feldstein, Leora R.;Rose, Erica B.;Randolph, Adrienne G.
通讯作者：
Randolph, Adrienne G.
影响因子：
168.9
作者：
Zhou, Fei;Yu, Ting;Cao, Bin
通讯作者：
Cao, Bin