对儿童多系统炎症综合征的心脏参与的审查
Tarek Alsaied1, Adriana H Tremoulet2, Jane C Burns2
1The Heart Institute, Cincinnati Children's Hospital Medical Center, Department of Pediatrics, University of Cincinnati College of Medicine, OH(T.A., S.M.L.).
Circulation
|November 9, 2020
概括
儿童多系统炎症综合征 (MIS-C) 是COVID-19感染后的一种罕见但严重的疾病. 它引起严重的炎症, 特别影响心脏, 需要立即的医疗照顾.
科学领域:
- 儿童传染病
- 儿童心脏病学
- 免疫学
背景情况:
- 由SARS-CoV-2引起的COVID-19可能会导致儿童患有称为MIS-C的严重炎症.
- MIS-C与毒性休克综合征和川崎病有相同的特征,报告的病例超过600例.
- 这种综合症对美国的黑人和西班牙裔儿童的影响不成比例.
研究的目的:
- 审查已公布的MIS-C数据,特别关注心脏并发症.
- 为MIS-C儿童进行心脏评估和随访提供临床指导.
主要方法:
- 关于MIS-C的已发表数据的文献审查.
- 对临床表现的分析,重点是心血管表现.
- 目前治疗策略和结果的总结.
主要成果:
- 通常在SARS-CoV-2感染后几周出现MIS-C,通常伴有发烧和胃肠道症状.
- 常见的心脏问题包括心室功能障碍,冠状动脉扩张/动脉瘤和心律失常.
- 严重的病例可能导致冲击,需要密集的支持,包括机械通风和ECMO.
结论:
- 儿童的MIS-C是COVID-19后的一种严重并发症,其特征是系统性炎症和频繁的心脏干扰.
- 免疫调节治疗是标准的,大多数儿童都能康复,但长期后果尚不清楚.
- 密切的心脏监测和随访对于管理MIS-C患者至关重要.
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