American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 and Hyperinflammation in Pediatric COVID-19: Version 2.
American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 and Hyperinflammation in Pediatric COVID-19: Version 2.
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DOI：
10.1002/art.41616
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发表时间：
2021-04
期刊：
影响因子：
--
通讯作者：
Mehta JJ
中科院分区：
文献类型：
--
作者：
Henderson LA;Canna SW;Friedman KG;Gorelik M;Lapidus SK;Bassiri H;Behrens EM;Ferris A;Kernan KF;Schulert GS;Seo P;Son MBF;Tremoulet AH;Yeung RSM;Mudano AS;Turner AS;Karp DR;Mehta JJ
为儿童多系统炎症综合征（MIS-C）的管理提供指导，MIS-C是一种以发热、炎症和多器官功能障碍为特征的疾病，在严重急性呼吸系统综合征冠状病毒2（SARS-CoV-2）感染的晚期出现。还为2019年冠状病毒病（COVID-19）期间炎症过度的儿童提供了建议，这是SARS-CoV-2感染的急性传染期。工作组由9名儿科风湿病学家和2名成人风湿病学家、2名儿科心脏病学家、2名儿科传染病专家和1名儿科重症监护医生组成。根据证据报告，制定了解决与MIS-C和COVID-19炎症过度相关的临床问题的初步声明。通过修改后的德尔菲过程，包括匿名投票和网络研讨会讨论建立共识。使用9分制来确定每个陈述的适当性（不适当的中位数评分为1-3分，不确定的中位数评分为4-6分，适当的中位数评分为7-9分）。根据投票的分散程度，共识被评为低、中或高。批准的指导声明是那些被归类为适当的中等或高水平的共识，这是预先规定的表决前。该指南的第一版于2020年6月获得批准，包括40个最终指南声明，并附有描述MIS-C诊断路径的流程图。该文件于2020年11月进行了修订，并增加了一个新的流程图，其中包括MIS-C初始免疫调节治疗的建议。我们对儿科人群中SARS-CoV-2相关综合征的理解继续发展。本指南文件反映了现有的证据和专家意见，并将根据进一步的证据进行修订。
To provide guidance on the management of Multisystem Inflammatory Syndrome in Children (MIS-C), a condition characterized by fever, inflammation, and multiorgan dysfunction that manifests late in the course of severe acute respiratory syndrome coronavirus 2 (SARS–CoV-2) infection. Recommendations are also provided for children with hyperinflammation during coronavirus disease 2019 (COVID-19), the acute, infectious phase of SARS–CoV-2 infection. The Task Force was composed of 9 pediatric rheumatologists and 2 adult rheumatologists, 2 pediatric cardiologists, 2 pediatric infectious disease specialists, and 1 pediatric critical care physician. Preliminary statements addressing clinical questions related to MIS-C and hyperinflammation in COVID-19 were developed based on evidence reports. Consensus was built through a modified Delphi process that involved anonymous voting and webinar discussion. A 9-point scale was used to determine the appropriateness of each statement (median scores of 1–3 for inappropriate, 4–6 for uncertain, and 7–9 for appropriate). Consensus was rated as low, moderate, or high based on dispersion of the votes. Approved guidance statements were those that were classified as appropriate with moderate or high levels of consensus, which were prespecified before voting. The first version of the guidance was approved in June 2020, and consisted of 40 final guidance statements accompanied by a flow diagram depicting the diagnostic pathway for MIS-C. The document was revised in November 2020, and a new flow diagram with recommendations for initial immunomodulatory treatment of MIS-C was added. Our understanding of SARS–CoV-2–related syndromes in the pediatric population continues to evolve. This guidance document reflects currently available evidence coupled with expert opinion, and will be revised as further evidence becomes available.
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影响因子：
5.1
作者：
Capone, Christine A.;Subramony, Anupama;Davidson, Karina W.
通讯作者：
Davidson, Karina W.
DOI：
10.1111/jth.14849
发表时间：
2020-07
期刊：
Journal of thrombosis and haemostasis : JTH
影响因子：
--
作者：
通讯作者：
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影响因子：
8.8
作者：
Cao, Bin;Gao, Hainv;Li, Lanjuan
通讯作者：
Li, Lanjuan
影响因子：
15.9
作者：
Chen, Guang;Wu, Di;Ning, Qin
通讯作者：
Ning, Qin
影响因子：
8
作者：
Dionne, Audrey;Mah, Douglas Y.;Friedman, Kevin G.
通讯作者：
Friedman, Kevin G.