Multisystem inflammatory syndrome in children associated with COVID-19 in 101 cases from Turkey (Turk-MISC study).

Autor: Yilmaz Ciftdogan D; Department of Pediatric Infectious Diseases, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey.; Department of Pediatric Infectious Diseases, Faculty of Medicine, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey., Ekemen Keles Y; Department of Pediatric Infectious Diseases, Faculty of Medicine, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey., Karbuz A; Department of Pediatric Infectious Diseases, Istanbul Professor Doctor Cemil Tascioglu City Hospital, Istanbul, Turkey., Cetin BS; Department of Pediatric Infectious Diseases, Faculty of Medicine, Erciyes University, Kayseri, Turkey., Elmas Bozdemir S; Department of Pediatric Infectious Diseases, Bursa Dortcelik Children's Hospital, Bursa, Turkey., Kepenekli Kadayifci E; Department of Pediatric Infectious Diseases, Faculty of Medicine, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey., Metin Akcan O; Department of Pediatric Infectious Diseases, Faculty of Medicine, Necmettin Erbakan University, Meram Hospital, Konya, Turkey., Ozer A; Division of Pediatric Infectious Diseases, Van Training and Research Hospital, University of Health Sciences, Van, Turkey., Erat T; Division of Pediatric Infectious Diseases, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey., Sutcu M; Department of Pediatric Infectious Diseases, Faculty of Medicine, Istinye University Hospital, Istanbul, Turkey., Buyukcam A; Division of Pediatric Infectious Diseases, Gaziantep CG Obstetrics and Children's Hospital, Gaziantep, Turkey., Belet N; Department of Pediatric Infectious Diseases, Faculty of Medicine, Dokuz Eylul University Hospital, İzmir, Turkey., Erdeniz EH; Department of Pediatric Infectious Diseases, Ondokuz Mayis University Hospital, Samsun, Turkey., Dalgic Karabulut N; Division of Pediatric Infectious Diseases, Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey., Hancerli Torun S; Department of Pediatric Infectious Diseases, Faculty of Medicine, Istanbul University Hospital, Istanbul, Turkey., Oncel S; Department of Pediatric Infectious Diseases, Faculty of Medicine, Kocaeli University Hospital, Kocaeli, Turkey., Orbak Z; Department of Pediatrics, Faculty of Dentistry and Medicine, Atatürk University, Erzurum, Turkey., Turel O; Department of Pediatric Infectious Diseases, Faculty of Medicine, Bezmialem Vakif University Hospital, Istanbul, Turkey., Gayretli Aydin ZG; Department of Pediatric Infectious Diseases, Faculty of Medicine, Karadeniz Teknik University Hospital, Trabzon, Turkey., Kilic O; Department of Pediatric Infectious Diseases, Faculty of Medicine, Osmangazi University Hospital, Eskisehir, Turkey., Yahsi A; Division of Pediatric Infectious Diseases, Samsun Training and Research Hospital, University of Health Sciences, Samsun, Turkey., Kara Aksay A; Department of Pediatric Infectious Diseases, Faculty of Medicine, Izmir Tepecik Training and Research Hospital, University of Health Sciences, Izmir, Turkey., Ergenc Z; Department of Pediatric Infectious Diseases, Faculty of Medicine, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey., Petmezci MT; Department of Intensive Care, Istanbul Professor Doctor Cemil Tascioglu City Hospital, Istanbul, Turkey., Oflaz MB; Department of Pediatric Cardiology, Faculty of Medicine, Necmettin Erbakan University, Meram Hospital, Konya, Turkey., Sarikaya R; Division of Cardiology, Van Training and Research Hospital, University of Health Sciences, Van, Turkey., Otar Yener G; Division of Pediatric Romatology, Sanliurfa Training and Research Hospital, Sanliurfa, Turkey., Ozen S; Department of Pediatric Infectious Diseases, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey., Gul D; Department of Pediatrics, Faculty of Medicine, Istinye University Hospital, Istanbul, Turkey., Arslan G; Department of Pediatric Intensive Care, Faculty of Medicine, Dokuz Eylul University Hospital, İzmir, Turkey., Kara SS; Department of Pediatric Infectious Diseases, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, Turkey., Demirkol D; Department of Pediatric Intensive Care, Faculty of Medicine, Istanbul University Hospital, Istanbul, Turkey., Yazici Ozkaya P; Department of Pediatric Intensive Care, Faculty of Medicine, Ege University Hospital, Izmir, Turkey., Yozgat Y; Department of Pediatric Cardiology, Faculty of Medicine, Bezmialem Vakif University Hospital, Istanbul, Turkey., Varan C; Department of Pediatric Cardiology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey., Kara M; Division of Pediatric Infectious Diseases, Necip Fazil City Hospital, Kahramanmaras, Turkey., Arga G; Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University Hospital, Ankara, Turkey., Yakut N; Department of Pediatric Infectious Diseases, Faculty of Medicine, Pendik Training and Research Hospital, Marmara University, Istanbul, Turkey., Kilic AO; Department of Pediatrics, Faculty of Medicine, Necmettin Erbakan University, Meram Hospital, Konya, Turkey., Cakici O; Department of Pediatric Infectious Diseases, Faculty of Medicine, Kocaeli University Hospital, Kocaeli, Turkey., Kucuk M; Division of Pediatric Cardiolgy, Samsun Training and Research Hospital, University of Health Sciences, Samsun, Turkey., Kaba O; Department of Pediatric Infectious Diseases, Faculty of Medicine, Istanbul University Hospital, Istanbul, Turkey., Karaoglu Asrak H; Department of Pediatric Infectious Diseases, Faculty of Medicine, Dokuz Eylul University Hospital, İzmir, Turkey., Bursal Duramaz B; Department of Pediatric Infectious Diseases, Faculty of Medicine, Bezmialem Vakif University Hospital, Istanbul, Turkey., Dalkiran T; Division of Pediatric Intensive Care, Necip Fazil City Hospital, Kahramanmaras, Turkey., Berna Anil A; Department of Pediatric Intensive Care, Faculty of Medicine, Izmir Katip Celebi University, Izmir, Turkey., Turgut M; Department of Pediatric Infectious Diseases, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey., Karapinar B; Department of Pediatric Intensive Care, Faculty of Medicine, Ege University Hospital, Izmir, Turkey., Somer A; Department of Pediatric Infectious Diseases, Faculty of Medicine, Istanbul University Hospital, Istanbul, Turkey., Elmali F; Department of Biostatistics, Izmir Katip Celebi University, Izmir, Turkey., Dinleyici EC; Department of Pediatrics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, Turkey., Ciftci E; Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University Hospital, Ankara, Turkey., Kara A; Department of Pediatric Infectious Diseases, Faculty of Medicine, Hacettepe University Hospital, Ankara, Turkey.
Jazyk: angličtina
Zdroj: Journal of paediatrics and child health [J Paediatr Child Health] 2022 Jun; Vol. 58 (6), pp. 1069-1078. Date of Electronic Publication: 2022 Feb 24.
DOI: 10.1111/jpc.15913
Abstrakt: Aim: Multisystem inflammatory syndrome in children (MIS-C) may cause shock and even death in children. The aim of this study is to describe the clinical features, laboratory characteristics and outcome of children diagnosed with MIS-C in 25 different hospitals in Turkey.
Methods: The retrospective study was conducted between 8 April and 28 October 2020 in 25 different hospitals from 17 cities. Data were collected from patients' medical records using a standardised form. Clinical and laboratory characteristics and outcomes according to different age groups, gender and body mass index percentiles were compared using multivariate logistic regression analysis.
Results: The study comprised 101 patients, median age 7 years (interquartile range (IQR) 4.6-9.3); 51 (50.5%) were boys. Reverse-transcriptase polymerase chain reaction (PCR) assay was positive in 21/100 (21%) patients; 62/83 (74.6%) patients had positive serology for SARS-CoV-2. The predominant complaints were fever (100%), fatigue (n = 90, 89.1%), and gastrointestinal symptoms (n = 81, 80.2%). Serum C-reactive protein (in 101 patients, median 165 mg/L; range 112-228), erythrocyte sedimentation rate (73/84, median 53 mm/s; IQR 30-84) and procalcitonin levels (86/89, median 5 μg/L; IQR 0.58-20.2) were elevated. Thirty-eight patients (37.6%) required admission to intensive care. Kawasaki disease (KD) was diagnosed in 70 (69.3%) patients, 40 of whom had classical KD. Most patients were treated with intravenous immunoglobulin (n = 92, 91%) and glucocorticoids (n = 59, 58.4%). Seven patients (6.9%) died.
Conclusion: The clinical spectrum of MIS-C is broad, but clinicians should consider MIS-C in the differential diagnosis when persistent fever, fatigue and gastrointestinal symptoms are prominent. Most patients diagnosed with MIS-C were previously healthy. Immunomodulatory treatment and supportive intensive care are important in the management of cases with MIS-C. Glucocorticoids and intravenous immunoglobulins are the most common immunomodulatory treatment options for MIS-C. Prompt diagnosis and prompt treatment are essential for optimal management.
(© 2022 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).)
Databáze: MEDLINE
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