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The clinical course and short-term health outcomes of multisystem inflammatory syndrome in children in the single pediatric rheumatology center.
Sözeri, Betül; Çaglayan, Sengül; Atasayan, Vildan; Ulu, Kadir; Coskuner, Taner; Pelin Akbay, Özge; Hasbal Akkus, Canan; Atay, Gürkan; Sali, Enes; Karacan, Mehmet; Öner, Taliha; Erdogan, Seher; Demir, Ferhat.
Afiliación
  • Sözeri B; Department of Pediatric Rheumatology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
  • Çaglayan S; Department of Pediatric Rheumatology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
  • Atasayan V; Department of Pediatric Cardiology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
  • Ulu K; Department of Pediatric Rheumatology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
  • Coskuner T; Department of Pediatric Rheumatology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
  • Pelin Akbay Ö; Department of Pediatrics, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
  • Hasbal Akkus C; Department of Pediatrics, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
  • Atay G; Department of Pediatric Intensive Care Unit, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
  • Sali E; Department of Pediatric Infectious Disease, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
  • Karacan M; Department of Pediatric Cardiology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
  • Öner T; Department of Pediatric Cardiology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
  • Erdogan S; Department of Pediatric Intensive Care Unit, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
  • Demir F; Department of Pediatric Rheumatology, Umraniye Training and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Postgrad Med ; 133(8): 994-1000, 2021 Nov.
Article en En | MEDLINE | ID: mdl-34605352
OBJECTIVES: Multisystem inflammatory syndrome in children (MIS-C) is a rare but severe condition resulting in excessive response of the immune system after SARS-CoV-2 infection. We report a single-center cohort of children with MIS-C, describing the spectrum of presentation, therapies, clinical course, and short-term outcomes. METHODS: This is a prospective observational study from to a tertiary pediatric rheumatology center including patients (aged 1 month to 21 years) diagnosed with MIS-C between April 2020-April 2021. Demographic, clinical, laboratory results and follow-up data were collected through the electronic patient record system and analyzed. RESULTS: A total of 67 patients with MIS-C were included in the study. Fever was detected in all patients; gastrointestinal system symptoms were found in 67.2% of the patients, rash in 38.8%, conjunctivitis in 31.3%, hypotension in 26.9% myocarditis, and/or pericarditis in 22.4%, respectively. Respiratory symptoms were only in five patients (7.5%). Kawasaki Disease like presentation was found 37.3% of the patients. The mean duration of hospitalization was 11.8 7.07 days. Fifty-seven patients (85%) received intravenous immunoglobulin (IVIG), 45 (67%) received corticosteroids, 17 (25.3%) received anakinra, and one (1.5%) received tocilizumab. Seven of the patients (10.4%) underwent therapeutic plasma exchange (TPE). In 21 (31.3%) patients, a pediatric intensive care unit (PICU) was required in a median of 2 days. The first finding to improve was fever, while the first parameter to decrease was ferritin (median 6.5 days (IQR, 4-11.2 days)). Sixty-five patients were discharged home with a median duration of hospital stay of 10 days (IQR, 7-15 days). CONCLUSION: Patients with MIS-C may have severe cardiac findings and intensive care requirements in admission and hospital follow-up. The vast majority of these findings improve with effective treatment without any sequelae until discharge and in a short time in follow-up. Although the pathogenesis and treatment plan of the disease are partially elucidated, follow-up studies are needed in terms of long-term prognosis and relapse probabilities.
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Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Reumatología / Unidades de Cuidado Intensivo Pediátrico / Síndrome de Respuesta Inflamatoria Sistémica / COVID-19 Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: Postgrad Med Año: 2021 Tipo del documento: Article País de afiliación: Turquía

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Reumatología / Unidades de Cuidado Intensivo Pediátrico / Síndrome de Respuesta Inflamatoria Sistémica / COVID-19 Tipo de estudio: Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Child / Child, preschool / Female / Humans / Infant / Male / Newborn Idioma: En Revista: Postgrad Med Año: 2021 Tipo del documento: Article País de afiliación: Turquía