Characteristics of pediatric multi-system inflammatory syndrome (PMIS) associated with COVID-19: a meta-analysis and insights into pathogenesis.
Characteristics of pediatric multi-system inflammatory syndrome (PMIS) associated with COVID-19: a meta-analysis and insights into pathogenesis.
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DOI：
10.1016/j.ijid.2020.11.145
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Jia X
中科院分区：
文献类型：
--
作者：
Zou H;Lu J;Liu J;Wong JH;Cheng S;Li Q;Shen Y;Li C;Jia X
儿科多系统炎症综合征(PMIS)最近在多个国家暴发，并被怀疑与SARS-CoV-2感染有关。目前，PMIs尚无标准化的诊断标准和治疗方案，病因和发病机制尚不清楚。我们对PubMed和Embase从成立之时到2020年6月24日进行了系统的回顾，以寻找相关的案例。共纳入7项研究，80%的患者出现持续发热，90%的患者出现胃肠道症状。81%的患者SARS-CoV-2抗体阳性，37%的患者核酸阳性。C-反应蛋白、IL-6和PCT升高，静脉注射免疫球蛋白是PMIs的常规治疗。超过一半的患者需要正性肌力支持，33%的患者需要机械通气。住院时间的中位数为10.66天，74%的患者接受过重症监护。我们的研究记录了三种常见的PMIs临床表现：持续发热和胃肠道症状、休克伴心功能障碍和川崎病样综合征。PMIS患者具有明显的炎症状态，可能与SARS-CoV-2感染有关。
There was an outbreak of pediatric multisystem inflammation syndrome (PMIS) was observed in multiple countries recently, and this syndrome was suspected to be associated with SARS-CoV-2 infection. At present, there is still no standardized diagnostic criteria and treatment regimen for PMIS, while the etiology and pathogenesis still remain unclear. We performed a systematic review on PubMed and Embase from the time of inception to June 24th 2020 in order to find relevant cases. There are seven studies included, and 80% of patients suffered persistent fever and 90% appeared gastrointestinal symptoms. IgG antibody against SARS-CoV-2 was positive on 81% of patients, while 37% of the patients were nucleic acid positive. C-reactive protein, IL-6 and PCT were elevated and intravenous immunoglobulin was a routine treatment for PMIS. There were more than half of patients required inotropic supports and mechanical ventilation were applied to 33% of patients. The median length of hospital stay was 10.66 days and 74% had admitted to accept intensive care. Our study documented three common types of PMIS clinical presentation: persistent fever and gastrointestinal symptoms, shocked with heart dysfunction and Kawasaki disease-like syndrome. PMIS patients proved with a marked inflammatory state were possibly associated with SARS-CoV-2 infection.
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