Multisystem inflammatory syndrome in children with COVID-19
| Autor: | Rachel E Bridwell, Michael Gottlieb, Joseph J. Ravera, Brit Long |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Resuscitation
medicine.medical_specialty Adolescent Point-of-Care Systems MIS-C Pediatrics Article law.invention 03 medical and health sciences 0302 clinical medicine law Adrenal Cortex Hormones Acute care medicine Humans Intensive care medicine Child Ultrasonography Aspirin Thrombocytosis business.industry SARS-CoV-2 Infant Newborn COVID-19 Immunoglobulins Intravenous Infant 030208 emergency & critical care medicine Shock General Medicine medicine.disease Intensive care unit Systemic Inflammatory Response Syndrome Review article Shock (circulatory) Child Preschool Emergency Medicine medicine.symptom Complication business Emergency Service Hospital medicine.drug |
| Zdroj: | The American Journal of Emergency Medicine |
| ISSN: | 1532-8171 0735-6757 |
| Popis: | Background Multisystem inflammatory syndrome in children (MIS-C) is a dangerous pediatric complication of COVID-19. Objective The purpose of this review article is to provide a summary of the diagnosis and management of MIS-C with a focus on management in the acute care setting. Discussion MIS-C is an inflammatory syndrome which can affect nearly any organ system. The most common symptoms are fever and gastrointestinal symptoms, though neurologic and dermatologic findings are also well-described. The diagnosis includes a combination of clinical and laboratory testing. Patients with MIS-C will often have elevated inflammatory markers and may have an abnormal electrocardiogram or echocardiogram. Initial treatment involves resuscitation with careful assessment for cardiac versus vasodilatory shock using point-of-care ultrasound. Treatment should include intravenous immunoglobulin, anticoagulation, and consideration of corticosteroids. Interleukin-1 and/or interleukin-6 blockade may be considered for refractory cases. Aspirin is recommended if there is thrombocytosis or Kawasaki disease-like features on echocardiogram. Patients will generally require admission to an intensive care unit. Conclusion MIS-C is a condition associated with morbidity and mortality that is increasingly recognized as a potential complication in pediatric patients with COVID-19. It is important for emergency clinicians to know how to diagnose and treat this disorder. |
| Databáze: | OpenAIRE |
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