Multisystem inflammatory syndrome in pediatric COVID-19 patients: a meta-analysis.

Autor: Toraih EA; Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA. etoraih@tulane.edu.; Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. etoraih@tulane.edu., Hussein MH; Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA., Elshazli RM; Department of Biochemistry and Molecular Genetics, Faculty of Physical Therapy, Horus University-Egypt, New Damietta, 34517, Egypt., Kline A; Tulane University, School of Medicine, New Orleans, LA, USA., Munshi R; Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, 70112, USA., Sultana N; Department of Medicine, Larkin Community Hospital, Florida, Miami, USA., Taghavi S; Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA., Killackey M; Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA., Duchesne J; Trauma/Acute Care and Critical Care, Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA., Fawzy MS; Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt.; Department of Biochemistry, College of Medicine, Northern Border University, Arar, Kingdom of Saudi Arabia., Kandil E; Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA, 70112, USA.
Jazyk: angličtina
Zdroj: World journal of pediatrics : WJP [World J Pediatr] 2021 Apr; Vol. 17 (2), pp. 141-151. Date of Electronic Publication: 2021 Feb 20.
DOI: 10.1007/s12519-021-00419-y
Abstrakt: Background: We aimed to systematically review the clinical and laboratory features of patients with the multisystem inflammatory syndrome in pediatrics diagnosed during the COVID-19 pandemic.
Data Sources: A literature search in Web of Science, PubMed, Scopus, and Science Direct was made up to June 29, 2020.
Results: Analysis of 15 articles (318 COVID-19 patients) revealed that although many patients presented with the typical multisystem inflammatory syndrome in pediatrics, Kawasaki-like features as fever (82.4%), polymorphous maculopapular exanthema (63.7%), oral mucosal changes (58.1%), conjunctival injections (56.0%), edematous extremities (40.7%), and cervical lymphadenopathy (28.5%), atypical gastrointestinal (79.4%) and neurocognitive symptoms (31.8%) were also common. They had elevated serum lactic acid dehydrogenase, D-dimer, C-reactive protein, procalcitonin, interleukin-6, troponin I levels, and lymphopenia. Nearly 77.0% developed hypotension, and 68.1% went into shock, while 41.1% had acute kidney injury. Intensive care was needed in 73.7% of cases; 13.2% were intubated, and 37.9% required mechanical ventilation. Intravenous immunoglobulins and steroids were given in 87.7% and 56.9% of the patients, respectively, and anticoagulants were utilized in 67.0%. Pediatric patients were discharged after a hospital stay of 6.77 days on average (95% CI 4.93-8.6).
Conclusions: Recognizing the typical and atypical presentation of the multisystem inflammatory syndrome in pediatric COVID-19 patients has important implications in identifying children at risk. Monitoring cardiac and renal decompensation and early interventions in patients with multisystem inflammatory syndrome is critical to prevent further morbidity.
Databáze: MEDLINE
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