Multi-system inflammatory syndrome in childrenadolescents (MIS-C): A systematic review of clinical features and presentation
Autor: | James Cook, Jonathan Weale, Katharine Harman, Trisha Radia, Atul Gupta, Nia Williams, Pankaj Agrawal |
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Rok vydání: | 2020 |
Předmět: |
Pulmonary and Respiratory Medicine
Male medicine.medical_specialty Abdominal pain Adolescent hyperinflammatory shock MIS-C Article MIS‐C Internal medicine Severity of illness PIMS‐TS medicine Humans critically unwell Pediatrics Perinatology and Child Health severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Child Respiratory distress Kawasaki disease business.industry Incidence (epidemiology) COVID-19 medicine.disease Infliximab Neutrophilia Systemic Inflammatory Response Syndrome Multi-system inflammatory Syndrome Systemic inflammatory response syndrome Diarrhea Original Article: Covid 19 Pediatrics Perinatology and Child Health Female medicine.symptom myocarditis business PIMS-TS medicine.drug |
Zdroj: | Pediatric Pulmonology Paediatric Respiratory Reviews |
ISSN: | 1526-0550 |
Popis: | Background Multisystem inflammatory syndrome in children (MIS‐C) associated with coronavirus disease 2019 has been increasingly recognized. However, the clinical features of MIS‐C and the differences from Kawasaki disease remain unknown. The study aims to investigate the epidemiology and clinical course of MIS‐C. Methods PubMed and EMBASE were searched through August 30, 2020. Observational studies describing MIS‐C were included. Data regarding demographic features, clinical symptoms, laboratory, echocardiography and radiology findings, treatments, and outcomes were extracted. Study‐specific estimates were combined using one‐group meta‐analysis in a random‐effects model. Results A total of 27 studies were identified including 917 MIS‐C patients. The mean age was 9.3 (95% confidence interval [CI], 8.4–10.1). The pooled proportions of Hispanic and Black cases were 34.6% (95% CI, 28.3–40.9) and 31.5% (95% CI, 24.8–38.1), respectively. The common manifestations were gastrointestinal symptoms (87.3%; 95% CI, 82.9–91.6) and cardiovascular involvement such as myocardial dysfunction (55.3%; 95% CI, 42.4–68.2), coronary artery aneurysms (21.7%; 95% CI, 12.8–30.1) and shock (65.8%; 95% CI, 51.1–80.4), with marked elevated inflammatory and cardiac markers. The majority of patients received intravenous immunoglobulin (81.0%; 95% CI, 75.0–86.9), aspirin (67.3%; 95% CI, 48.8–85.7), and corticosteroids (63.6%; 95% CI, 53.4–73.8) with a variety of anti‐inflammatory agents. Although myocardial dysfunction improved in 55.1% (95% CI, 33.4–76.8) at discharge, the rate of extracorporeal membrane oxygenation use was 6.3% (95% CI, 2.8–9.8) and the mortality was 1.9% (95% CI, 1.0–2.8). Conclusion Our findings suggest that MIS‐C leads to multiple organ failure, including gastrointestinal manifestations, myocardial dysfunction and coronary abnormalities, and has distinct features from Kawasaki disease. |
Databáze: | OpenAIRE |
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