Cardiac echocardiogram findings of severe acute respiratory syndrome coronavirus-2-associated multi-system inflammatory syndrome in children.
Cardiac echocardiogram findings of severe acute respiratory syndrome coronavirus-2-associated multi-system inflammatory syndrome in children.
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DOI：
10.1017/s1047951121003024
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发表时间：
2022-05
影响因子：
1
通讯作者：
Sable CA
中科院分区：
文献类型：
--
作者：
Harahsheh AS;Krishnan A;DeBiasi RL;Olivieri LJ;Spurney C;Donofrio MT;Cross RR;Sharron MP;Frank LH;Berul CI;Christopher A;Dham N;Srinivasalu H;Ronis T;Smith KL;Kline JN;Parikh K;Wessel D;Bost JE;Litt S;Austin A;Zhang J;Sable CA
2019年冠状病毒病大流行期间，出现了一种新的儿科疾病--儿童多系统炎症综合征。目的：描述儿童多系统炎症综合征患者心脏并发症及相关危险因素的短期演变。对2020年3月29日至2020年9月1日期间接受治疗的儿童确诊的多系统炎症综合征的单中心回顾性研究。急性期心脏并发症定义为收缩功能减退、冠状动脉异常、心包积液或二尖瓣和/或三尖瓣返流。对有或无心脏并发症的患者进行卡方检验、Fisher‘s Exact检验和Wilcoxon秩和检验。39名儿童的年龄中位数(四分位数范围)为7.8(3.6-12.7)岁。19例(49%)患者出现心脏并发症，包括收缩功能不全(33%)、瓣膜返流(31%)、冠状动脉异常(18%)和心包积液(5%)。在最近一次随访时，中位数(四分位数范围)为49天(26-61天)，16/19(84%)患者的心脏并发症得到缓解。2例患者有持续性轻度收缩功能障碍，1例患者有持续性冠状动脉异常。有心脏并发症的儿童更容易出现N端B型利钠肽(p=0.01)、白细胞计数(p=0.01)、中性粒细胞计数(p=0.02)、严重淋巴细胞减少(p=0.05)、使用米力农(p=0.03)和需要重症监护(p=0.04)。儿童多系统炎症综合征患者急性期心脏并发症发生率高，并伴有相关的炎症标志物。虽然84%的患者心脏并发症得到解决，但仍需要进一步的长期研究来评估心脏异常(暂时性或持续性)是否与主要心脏事件有关。
A novel paediatric disease, multi-system inflammatory syndrome in children, has emerged during the 2019 coronavirus disease pandemic. To describe the short-term evolution of cardiac complications and associated risk factors in patients with multi-system inflammatory syndrome in children. Retrospective single-centre study of confirmed multi-system inflammatory syndrome in children treated from 29 March, 2020 to 1 September, 2020. Cardiac complications during the acute phase were defined as decreased systolic function, coronary artery abnormalities, pericardial effusion, or mitral and/or tricuspid valve regurgitation. Patients with or without cardiac complications were compared with chi-square, Fisher’s exact, and Wilcoxon rank sum. Thirty-nine children with median (interquartile range) age 7.8 (3.6–12.7) years were included. Nineteen (49%) patients developed cardiac complications including systolic dysfunction (33%), valvular regurgitation (31%), coronary artery abnormalities (18%), and pericardial effusion (5%). At the time of the most recent follow-up, at a median (interquartile range) of 49 (26–61) days, cardiac complications resolved in 16/19 (84%) patients. Two patients had persistent mild systolic dysfunction and one patient had persistent coronary artery abnormality. Children with cardiac complications were more likely to have higher N-terminal B-type natriuretic peptide (p = 0.01), higher white blood cell count (p = 0.01), higher neutrophil count (p = 0.02), severe lymphopenia (p = 0.05), use of milrinone (p = 0.03), and intensive care requirement (p = 0.04). Patients with multi-system inflammatory syndrome in children had a high rate of cardiac complications in the acute phase, with associated inflammatory markers. Although cardiac complications resolved in 84% of patients, further long-term studies are needed to assess if the cardiac abnormalities (transient or persistent) are associated with major cardiac events.