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

Autor: Dilek Yilmaz Ciftdogan, Yildiz Ekemen Keles, Adem Karbuz, Benhur Sirvan Cetin, Sefika Elmas Bozdemir, Eda Kepenekli Kadayifci, Ozge Metin Akcan, Arife Ozer, Tugba Erat, Murat Sutcu, Ayse Buyukcam, Nursen Belet, Emine Hafize Erdeniz, Nazan Dalgic Karabulut, Selda Hancerli Torun, Selim Oncel, Zerrin Orbak, Ozden Turel, Zeynep Gokce Gayretli Aydin, Omer Kilic, Aysun Yahsi, Ahu Kara Aksay, Zeynep Ergenc, Mey Talip Petmezci, Mehmet Burhan Oflaz, Remzi Sarikaya, Gülcin Otar Yener, Seval Ozen, Doruk Gul, Gazi Arslan, Soner Sertan Kara, Demet Demirkol, Pinar Yazici Ozkaya, Yilmaz Yozgat, Celal Varan, Manolya Kara, Gul Arga, Nurhayat Yakut, Ahmet Osman Kilic, Ozlem Cakici, Mehmet Kucuk, Ozge Kaba, Hatice Karaoglu Asrak, Burcu Bursal Duramaz, Tahir Dalkiran, Ayse Berna Anil, Mehmet Turgut, Bulent Karapinar, Ayper Somer, Ferhan Elmali, Ener Cagri Dinleyici, Ergin Ciftci, Ates Kara
Přispěvatelé: İstinye Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Murat Sütçü / 0000-0002-2078-9796, Doruk Gül / 0000-0003-2558-3719, Sütçü, Murat, Gül, Doruk, Murat Sütçü / ABG-7336-2021, Doruk Gül / AGJ-2448-2022, Murat Sütçü / 55499199300, Doruk Gül / 57222108765, Yilmaz Ciftdogan D., Ekemen Keles Y., Karbuz A., ÇETİN B. Ş., Elmas Bozdemir S., KEPENEKLİ KADAYİFCİ E., Metin Akcan O., Ozer A., Erat T., Sutcu M., et al., TÜREL, Özden, {{contributorinst}}
Jazyk: angličtina
Rok vydání: 2022
Předmět:
Popis: © 2022 Paediatrics and Child Health Division (The Royal Australasian College of Physicians).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.
Databáze: OpenAIRE
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