| Autor: |
Avrusin IS; Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia., Abramova NN; Intensive Care Unite Department, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia., Belozerov KE; Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia., Kondratiev GV; Pediatric Oncology Department, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia., Bregel LV; Department of Pediatrics, Irkutsk State Medical Academy of Postgraduate Education, Branch of Russian Medical Academy of Continuous Professional Education, Irkutsk 664049, Russia.; Department of Cardiology, Irkutsk Regional Children's Hospital, Irkutsk 664022, Russia., Efremova OS; Department of Pediatrics, Irkutsk State Medical Academy of Postgraduate Education, Branch of Russian Medical Academy of Continuous Professional Education, Irkutsk 664049, Russia.; Department of Cardiology, Irkutsk Regional Children's Hospital, Irkutsk 664022, Russia., Vilnits AA; Pediatric Infectious Department, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia.; The Research Department of Intensive Care of Emergency Conditions, Pediatric Research and Clinical Center for Infection Diseases, Saint Petersburg 197022, Russia., Konstantinova JE; The Research Department of Vaccination and Adverse Event Follow Immunization, Pediatric Research and Clinical Center for Infection Diseases, Saint Petersburg 197022, Russia., Isupova EA; Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia., Kornishina TL; Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia., Masalova VV; Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia., Felker EY; Intensive Care Unite Department, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia., Kalashnikova OV; Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia., Chasnyk VG; Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia., Aleksandrovich YS; Intensive Care Unite Department, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia., Kostik MM; Hospital Pediatry, Saint-Petersburg State Pediatric Medical University, Saint Petersburg 194100, Russia. |
| Abstrakt: |
Multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) is a life-threatening condition that often requires intensive care unit (ICU) admission. The aim of this study was to determine risk factors for severe/life-threatening course of MIS-C. The study included 166 patients (99 boys, 67 girls) aged 4 months-17 years (median 8.2 years). The criterion of severity was the fact of ICU admission. To conduct a comparative analysis, MIS-C patients were divided into two groups: patients hospitalized in the ICU ( n = 84, 50.6%) and those who did not need ICU admission ( n = 82, 49.4%). Patients with a more severe course of MIS-C were significantly older. They had a higher frequency of signs such as rash, swelling, hepatomegaly, splenomegaly, and neurological and respiratory symptoms. Hypotension/shock and myocardial involvement were much more common in patients with severe MIS-C. These patients had a more significant increase in CRP, creatinine, troponin, and D-dimer levels. Additionally, the presence of macrophage activation syndrome was higher in patients admitted to the ICU. Conclusion: Nineteen predictors of severe course of MIS-C were found, out of which hepatomegaly, splenomegaly, D-dimer > 2568 ng/mL, troponin > 10 pg/mL were mainly associated with the probability of being classified as early predictors of severe MIS-C requiring ICU admission. |
