COVID-19 and Multisystem Inflammatory Syndrome in Latin American Children A Multinational Study
COVID-19 and Multisystem Inflammatory Syndrome in Latin American Children A Multinational Study
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DOI：
10.1097/inf.0000000000002949
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发表时间：
2021-01-01
影响因子：
3.6
通讯作者：
Buonsenso, Danilo
中科院分区：
文献类型：
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作者：
Antunez-Montes, Omar Yassef;Escamilla, Maria Isabel;Buonsenso, Danilo
背景：迄今为止。拉丁美洲没有关于儿童COVID-19的全面数据。本研究旨在评估拉丁美洲儿童的COVID-19和多系统炎症综合征（MIS-C），以适当地规划和分配资源，以应对当地和国际层面的大流行。方法：来自5个拉丁美洲国家的双向多中心队列研究。结果：409名儿童被包括在内，平均年龄为3.0岁（四分之一范围0.6-9.0）。其中，95例（23.2%）被诊断为MIS-C。191名（46.7%）儿童入院治疗，52名（12.7%）需要入住儿科重症监护室。92例（22.5%）患者需要氧气支持：8例（2%）开始持续气道正压通气，29例（7%）开始机械通气。35例（8.5%）患者需要强心剂支持。以下因素与儿科重症监护病房入院相关：既往病史（P < 0.0001）。免疫缺陷（P = 0.01），下呼吸道感染（P < 0.0001），胃肠道症状（P- 0.006），放射学变化提示肺炎和急性呼吸窘迫综合征（P < 0.0001）和低社会经济条件（P = 0.009）。这项研究显示，与中国、欧洲和北美的研究相比，拉丁美洲儿童的COVID-19形式普遍更严重，MIS-C数量也很高，并支持目前拉丁/西班牙裔儿童或社会经济水平较低的人群中更严重疾病的证据。这些发现凸显了拉丁美洲迫切需要更多关于COVID-19的数据。
Background: To date. there are no comprehensive data on pediatric COVID-19 from Latin America. This study aims to assess COVID-19 and Multisystem Inflammatory Syndrome (MIS-C) in Latin American children, to appropriately plan and allocate resources to face the pandemic on a local and international level.Methods: Ambispective multicenter cohort study from 5 Latin American countries. Children 18 years of age or younger with microbiologically confirmed SARS-CoV-2 infection or fulfilling MIS-C definition were included.Findings: Four hundred nine children were included, with a median age of 3.0 years (interquarti le range 0.6-9.0). Of these, 95 (23.2%) were diagnosed with MIS-C. One hundred ninety-one (46.7%) children were admitted to hospital and 52 (12.7%) required admission to a pediatric intensive care unit. Ninety-two (22.5%) patients required oxygen support: 8 (2%) were started on continuous positive airway pressure and 29 (7%) on mechanical ventilation. Thirty-five (8.5%) patients required inotropic support. The following factors were associated with pediatric intensive care unit admission: preexisting medical condition (P < 0.0001). immunodeficiency (P = 0.01), lower respiratory tract infection (P < 0.0001), gastrointestinal symptoms (P- 0.006), radiologic changes suggestive of pneumonia and acute respiratory distress syndrome (P < 0.0001) and low socioeconomic conditions (P = 0.009).Conclusions: This study shows a generally more severe form of COVID-19 and a high number of MIS-C in Latin American children, compared with studies from China, Europe and North America, and support current evidence of a more severe disease in Latin/Hispanic children or in people of lower socioeconomic level. The findings highlight an urgent need for more data on COVID-19 in Latin America.