Multisystem inflammatory syndrome in children related to COVID-19: a systematic review.
Multisystem inflammatory syndrome in children related to COVID-19: a systematic review.
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DOI：
10.1007/s00431-021-03993-5
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发表时间：
2021-07
影响因子：
3.6
通讯作者：
Haerynck F
中科院分区：
文献类型：
--
作者：
Hoste L;Van Paemel R;Haerynck F
最近发表了一项新的儿科高炎症性疾病与SARS-CoV-2之间的关联，并将其命名为儿科炎症性多系统综合征，该综合征与SARS-CoV-2 （PIMS-TS）或多系统炎症综合征（儿童）（MIS(c)）暂时相关。我们对68例953例PIMS-TS/MIS(c)病例的流行病学、临床和预后特征进行了系统回顾和描述。此外，我们还研究了当前应用的不同案例定义的敏感性。PIMS-TS/MIS（-C）的发病年龄中位数为8岁。男性（58.9%）和少数民族（37.0%）的流行病学差异明显。除了肥胖（25.3%）外，合并症很少见。PIMS-TS/MIS（-C）的特征是发热（99.4%）、胃肠道（85.6%）和心血管系统表现（79.3%），以及炎症生物标志物升高。然而，50.3%的人也出现呼吸道症状。超过一半的患者（56.3%）出现休克。大多数患者（73.3%）需要重症监护治疗，其中体外膜氧合（ECMO）占3.8%。尽管疾病严重，但死亡率相当低（1.9%）。在目前使用的病例定义中，世卫组织的定义是首选，因为它更精确，同时涵盖了大多数病例。结论：PIMS-TS/MIS（-C）是一种流行病学丰富的男性、青少年和少数民族的严重异质性疾病。然而，死亡率低，短期预后良好。慢性并发症的长期随访和进一步的临床研究阐明潜在的发病机制是至关重要的。在线版本包含补充材料，可在10.1007/s00431-021-03993-5获得。
An association between a novel pediatric hyperinflammatory condition and SARS-CoV-2 was recently published and termed pediatric inflammatory multisystem syndrome, temporally associated with SARS-CoV-2 (PIMS-TS) or multisystem inflammatory syndrome (in children) (MIS(-C)). We performed a systematic review and describe the epidemiological, clinical, and prognostic characteristics of 953 PIMS-TS/MIS(-C) cases in 68 records. Additionally, we studied the sensitivity of different case definitions that are currently applied. PIMS-TS/MIS(-C) presents at a median age of 8 years. Epidemiological enrichment for males (58.9%) and ethnic minorities (37.0% Black) is present. Apart from obesity (25.3%), comorbidities are rare. PIMS-TS/MIS(-C) is characterized by fever (99.4%), gastrointestinal (85.6%) and cardiocirculatory manifestations (79.3%), and increased inflammatory biomarkers. Nevertheless, 50.3% present respiratory symptoms as well. Over half of patients (56.3%) present with shock. The majority of the patients (73.3%) need intensive care treatment, including extracorporal membrane oxygenation (ECMO) in 3.8%. Despite severe disease, mortality is rather low (1.9%). Of the currently used case definitions, the WHO definition is preferred, as it is more precise, while encompassing most cases. Conclusion: PIMS-TS/MIS(-C) is a severe, heterogeneous disease with epidemiological enrichment for males, adolescents, and racial and ethnic minorities. However, mortality rate is low and short-term outcome favorable. Long-term follow-up of chronic complications and additional clinical research to elucidate the underlying pathogenesis is crucial. The online version contains supplementary material available at 10.1007/s00431-021-03993-5.
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