Multisystem inflammatory syndrome in children (MIS-C): Report of the clinical and epidemiological characteristics of cases in Santiago de Chile during the SARS-CoV-2 pandemic
Multisystem inflammatory syndrome in children (MIS-C): Report of the clinical and epidemiological characteristics of cases in Santiago de Chile during the SARS-CoV-2 pandemic
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DOI：
10.1016/j.ijid.2020.08.062
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发表时间：
2020-11-01
影响因子：
8.4
通讯作者：
Tapia, Lorena I.
中科院分区：
文献类型：
--
作者：
Torres, Juan P.;Izquierdo, Giannina;Tapia, Lorena I.
目的：描述智利圣地亚哥儿童多系统炎症综合征（MIS-C）住院患儿的临床和流行病学特征。方法：这是一项对圣地亚哥三家儿科医院MIS-C患儿（2020年5月1日至6月24日）进行的观察性研究。人口统计学特征和流行病学数据，病史，实验室检查，心脏病学评价，治疗和临床outcomes进行了analyzed.Results：27例患者入院（中位年龄6，范围0-14岁）。27例患者中有16例（59%）需要入住重症监护室;无死亡病例。74%的患者没有合并症，入院前出现症状的中位天数为4天（范围2-9天）。胃肠道症状是最常见的，入院时炎症标志物增加。在82%的病例中检测到近期严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染。严重组在疾病进展过程中血红蛋白和白蛋白水平显著降低，血小板计数降低，D-二聚体升高。超声心动图显示异常（心肌，心包，或冠状动脉）在12名患者（46%）在他们的住院期间。24例患者接受抗炎治疗（免疫球蛋白和/或皮质类固醇）。MIS-C出现在SARS-CoV-2病例高峰后的数周内，特别是在最脆弱的圣地亚哥地区。结论：本研究描述了拉丁美洲国家MIS-C儿童的第一个系列（n = 27），显示出良好的临床结局。临床团队需要教育和警报，以建立早期诊断和及时治疗。(C)2020由Elsevier Ltd代表国际传染病学会发布。
Objective: To describe the clinical and epidemiological characteristics of hospitalized children with multisystem inflammatory syndrome in children (MIS-C) in Santiago, Chile.Methods: This was an observational study of children with MIS-C (May 1 to June 24, 2020), in three pediatric hospitals in Santiago. Demographic characteristics and epidemiological data, medical history, laboratory tests, cardiology evaluations, treatment, and clinical outcomes were analyzed.Results: Twenty-seven patients were admitted (median age 6, range 0-14 years). Sixteen of the 27 (59%) required intensive care unit admission; there were no deaths. Seventy-four percent had no comorbidities, and the median number of days of symptoms before admission was 4 (range 2-9 days). Gastrointestinal symptoms were the most frequent, and inflammatory markers were increased at admission. A recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was detected in 82% of cases. The severe group showed significantly lower hemoglobin and albumin levels, decreased platelet counts, and higher D-dimer during disease evolution. Echocardiography showed abnormalities (myocardial, pericardial, or coronary) in 12 patients (46%) during their hospital stay. Anti-inflammatory treatment (immunoglobulin and/or corticosteroids) was prescribed in 24 patients. MIS-C appeared in clusters weeks after the peak of SARS-CoV-2 cases, especially in the most vulnerable areas of Santiago.Conclusions: This study describes the first series (n = 27) of children with MIS-C in a Latin American country, showing favorable clinical outcomes. Education and alerts are required for clinical teams to establish an early diagnosis and prompt treatment. (C) 2020 Published by Elsevier Ltd on behalf of International Society for Infectious Diseases.