Evaluation of 601 children with multisystem inflammatory syndrome (Turk MISC study).

Autor: Yilmaz D; Izmir Katip Celebi University, Izmir, Turkey., Ekemen Keles Y; Health Sciences University Tepecik Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Gaziler Street Number: 468, 35020, Yenisehir Konak/Izmir, Turkey. kutupylz@hotmail.com., Emiroglu M; Selcuk University Hospital, Konya, Turkey., Duramaz BB; Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey., Ugur C; University of Health Sciences Konya Health Application and Research Center, Konya, Turkey., Aldemir Kocabas B; Antalya Training and Research Hospital, Antalya, Turkey., Celik T; Canakkale On Sekiz Mart University Hospital, Canakkale, Turkey., Ozdemir H; Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey., Bayturan S; Celal Bayar University Hospital, Manisa, Turkey., Turel O; Bezmialem Vakif University Hospital, Istanbul, Turkey., Erdeniz EH; Ondokuz Mayis University Hospital, Samsun, Turkey., Cakici O; Kocaeli University Hospital, Kocaeli, Turkey., Cakmak Taskin E; Erzurum Regional Training and Research Hospital, Erzurum, Turkey., Erbas İC; Dokuz Eylül University Hospital, Izmir, Turkey., Genceli M; Necmettin Erbakan University, Meram Hospital, Konya, Turkey., Sari EE; Health Science University İstanbul Bakırkoy Dr. Sadi Konuk Training and Research Hospital TR, Istanbul, Turkey., Caymaz C; Başakşehir Cam ve Sakura City Hospital, Istanbul, Turkey., Kizil MC; Eskişehir Osmangazi University Hospital, Eskişehir, Turkey., Sutcu M; İstinye University Hospital, Istanbul, Turkey., Demirbuga A; Istanbul University Hospital, Istanbul, Turkey., Alkan G; Selcuk University Hospital, Konya, Turkey., Bagcı Z; University of Health Sciences Konya Health Application and Research Center, Konya, Turkey., Timurtas Dayar G; Antalya Training and Research Hospital, Antalya, Turkey., Ozkan EA; Ondokuz Mayis University Hospital, Samsun, Turkey., Tekin Yilmaz A; Eskisehir City Hospital, Eskisehir, Turkey., Akca M; Mersin University Hospital, Mersin, Turkey., Yesil E; Mersin City Hospital, Mersin, Turkey., Kara SS; Aydin Adnan Menderes University Hospital, Aydin, Turkey., Akturk H; Koc University Hospital, Istanbul, Turkey., Yasar B; Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey., Umit Z; Manisa City Hospital, Manisa, Turkey., Uygun H; Adıyaman Research and Training Hospital, Adiyaman, Turkey., Erdem N; Adiyaman University Hospital, Adiyaman, Turkey., Buyukcam A; Ankara Gulhane Research and Training Hospital, Ankara, Turkey., Karadag Oncel E; Health Sciences University Tepecik Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Gaziler Street Number: 468, 35020, Yenisehir Konak/Izmir, Turkey., Tuter Oz SK; Selcuk University Hospital, Konya, Turkey., Cetin HS; Antalya Training and Research Hospital, Antalya, Turkey., Anil AB; Health Sciences University Tepecik Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Gaziler Street Number: 468, 35020, Yenisehir Konak/Izmir, Turkey.; Pediatric Intensive Care, Health Sciences University Tepecik Training and Research Hospital, Izmir, Izmir, Turkey., Yilmaz R; Selcuk University Hospital, Konya, Turkey., Zengin N; Celal Bayar University Hospital, Manisa, Turkey., Uzuner S; Bezmialem Vakif University Hospital, Istanbul, Turkey., Albayrak H; Ondokuz Mayis University Hospital, Samsun, Turkey., Borakay O; Kocaeli University Hospital, Kocaeli, Turkey., Topal S; Erzurum Regional Training and Research Hospital, Erzurum, Turkey., Arslan G; Dokuz Eylül University Hospital, Izmir, Turkey., Yazar A; Necmettin Erbakan University, Meram Hospital, Konya, Turkey., Ozer A; Health Sciences University Van Training and Research Hospital, Van, Turkey., Kendirli T; Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey.; Pediatric Intensive Care, Ankara University Hospital, Ankara, Turkey., Kara EM; İstinye University Hospital, Istanbul, Turkey., Demirkol D; Istanbul University Hospital, Istanbul, Turkey., Battal F; Canakkale On Sekiz Mart University Hospital, Canakkale, Turkey., Kosker M; Antalya Training and Research Hospital, Antalya, Turkey., Metin Akcan O; Necmettin Erbakan University, Meram Hospital, Konya, Turkey., Kihtir HS; Antalya Training and Research Hospital, Antalya, Turkey., Gul D; İstinye University Hospital, Istanbul, Turkey., Zararci K; Eskisehir City Hospital, Eskisehir, Turkey., Alakaya M; Mersin University Hospital, Mersin, Turkey., Kula N; Antalya Training and Research Hospital, Antalya, Turkey., Celik E; Aydin Adnan Menderes University Hospital, Aydin, Turkey., Petmezci E; Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey., Evren G; Manisa City Hospital, Manisa, Turkey., Kara Aksay A; Health Sciences University Tepecik Training and Research Hospital, Clinic of Pediatric Infectious Diseases, Gaziler Street Number: 468, 35020, Yenisehir Konak/Izmir, Turkey., Konca C; Adiyaman University Hospital, Adiyaman, Turkey., Sert A; Selcuk University Hospital, Konya, Turkey., Arslan D; University of Health Sciences Konya Health Application and Research Center, Konya, Turkey., Bornaun H; Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey., Tekeli O; Antalya Training and Research Hospital, Antalya, Turkey., Bal A; Celal Bayar University Hospital, Manisa, Turkey., Sahin IO; Ondokuz Mayis University Hospital, Samsun, Turkey., Demir S; Erzurum Regional Training and Research Hospital, Erzurum, Turkey., Sap F; Necmettin Erbakan University, Meram Hospital, Konya, Turkey., Akyol MB; Health Science University İstanbul Bakırkoy Dr. Sadi Konuk Training and Research Hospital TR, Istanbul, Turkey., Tanidir IC; Başakşehir Cam ve Sakura City Hospital, Istanbul, Turkey., Donmez YN; Health Sciences University Van Training and Research Hospital, Van, Turkey., Ucar T; Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey.; Pediatric Cardiology, Ankara University Hospital, Ankara, Turkey., Coban S; Erzurum Regional Training and Research Hospital, Erzurum, Turkey., Arga G; Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey., Hancerli Torun S; Istanbul University Hospital, Istanbul, Turkey., Karpuz D; Mersin University Hospital, Mersin, Turkey., Celik SF; Aydin Adnan Menderes University Hospital, Aydin, Turkey., Varan C; Adiyaman University Hospital, Adiyaman, Turkey., Elmali F; Izmir Katip Celebi University, Izmir, Turkey., Oncel S; Kocaeli University Hospital, Kocaeli, Turkey., Belet N; Dokuz Eylül University Hospital, Izmir, Turkey., Hatipoglu N; Health Science University İstanbul Bakırkoy Dr. Sadi Konuk Training and Research Hospital TR, Istanbul, Turkey., Dalgic Karabulut N; Health Sciences University Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey., Turgut M; Adiyaman University Hospital, Adiyaman, Turkey., Somer A; Istanbul University Hospital, Istanbul, Turkey., Kuyucu N; Mersin University Hospital, Mersin, Turkey., Dinleyici EC; Eskişehir Osmangazi University Hospital, Eskişehir, Turkey., Ciftci E; Department of Pediatric Infectious Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey., Kara A; Hacettepe University Hospital, Ankara, Turkey.
Jazyk: angličtina
Zdroj: European journal of pediatrics [Eur J Pediatr] 2023 Dec; Vol. 182 (12), pp. 5531-5542. Date of Electronic Publication: 2023 Oct 02.
DOI: 10.1007/s00431-023-05207-6
Abstrakt: Purpose: Due to its link with the 2019 coronavirus, the multisystem inflammatory syndrome in children (MISC) has garnered considerable international interest. The aim of this study, in which MISC patients were evaluated multicenter, and the data of the third period of the Turk-MISC study group, to compare the clinical and laboratory characteristics and outcomes of MISC patients who did and did not require admission to an intensive care unit (ICU).
Methods: This retrospective multicenter observational study was carried out between June 11, 2021, and January 01, 2022. The demographics, complaints, laboratory results, system involvements, and outcomes of the patients were documented.
Results: A total of 601 patients were enrolled; 157 patients (26.1%) required hospitalization in the intensive care unit (ICU). Median age was 8 years (interquartile range (IQR) 4.5-11.3 years. The proportion of Kawasaki disease-like features in the ICU group was significantly higher than in the non-ICU group (56.1% vs. 43.2% p = 0.006). The ICU group had considerably lower counts of both lymphocytes and platelets (lymphocyte count 900 vs. 1280 cells × μL, platelet count 153 vs. 212 cells × 10 3 / μL, all for p< 0.001). C-reactive protein, procalcitonin, and ferritin levels were significantly higher in the ICU group (CRP 164 vs. 129 mg/L, procalcitonin 9.2 vs. 2.2 μg/L, ferritin 644 vs. 334 μg/L, all for p< 0.001). Being between ages 5-12 and older than 12 increased the likelihood of hospitalization in the ICU by four [95% confidence intervals (CI)1.971-8.627] and six times (95% CI 2.575-14.654), respectively, compared to being between the ages 0-5. A one-unit increase in log D-dimer (µg/L) and log troponin (ng/L) was also demonstrated to increase the need for intensive care by 1.8 (95% CI 1.079-3.233) and 1.4 times (95% CI 1.133-1.789), respectively.     Conclusion: By comparing this study to our other studies, we found that the median age of MISC patients has been rising. Patients requiring an ICU stay had considerably higher levels of procalcitonin, CRP, and ferritin but significantly lower levels of lymphocyte and thrombocyte. In particular, high levels of procalcitonin in the serum might serve as a valuable laboratory marker for anticipating the need for intensive care.
What Is Known: • Lymphopenia and thrombocytopenia were an independent predictor factors in patients with MISC who needed to stay in intensive care unit. • The possibility of the need to stay in the intensive care unit in patients with MISC who had Kawasaki disease-like findings was controversial compared with those who did not.
What Is New: • A one-unit increase log D dimer and log troponin was demonstrated to require for intensive care unit by 1.8 and 1.4 times, respectively. • Serum procalcitonin levels had the best performance to predict stay in the intensive care unit stay.
(© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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