在COVID-19浪潮期间儿童的多系统炎症综合征:来自青少年炎症类风湿症队列的数据
Robin Kechiche1, Charlotte Borocco1, Fanny Bajolle2
1Department of Pediatric Rheumatology, Reference Centre for Autoinflammatory Diseases and Amyloidosis (CEREMAIA), Bicêtre University Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris-Saclay University, Le Kremlin-Bicêtre, France.
Frontiers in pediatrics
|June 9, 2023
概括
儿童多系统炎症综合征 (MIS-C) 病例在三个COVID-19波中变得不那么严重,症状和炎症减少. 改善管理,包括增加皮质类固醇的使用,有助于改善儿童的治疗结果.
科学领域:
- 儿童风湿病学和传染病学
- 公共卫生和流行病学
- 临界护理医学 临界护理医学
背景情况:
- 儿童多系统炎症综合征 (MIS-C) 在COVID-19大流行期间成为一个重大问题.
- 了解MIS-C不断变化的临床表现和管理对于儿科医疗保健提供者至关重要.
- 流行病的最初浪潮在诊断和治疗这种新型疾病方面提出了独特的挑战.
研究的目的:
- 确定儿童和青少年MIS-C的诊断轨迹.
- 通过连续的COVID-19浪潮来描述MIS-C的临床和生物特征.
- 评估治疗策略及其对大流行期间患者治疗结果的影响.
主要方法:
- 在青少年炎症性风湿症 (JIR) 队列中,对136名被诊断患有MIS-C的患者进行了回顾性分析.
- 数据收集时间从2020年3月到2021年6月,涵盖了COVID-19的前三个波.
- 在第一波和随后的波 (第二和第三波) 之间对患者数据进行比较分析.
主要成果:
- 在不同波段中观察到受影响儿童的平均年龄下降.
- 后来的波浪显示了腹,呼吸困难和心肌炎的发病率降低,以及炎症标志物 (例如,C反应性蛋白,中性粒细胞数量) 的减少.
- 治疗发生了变化,皮质类固醇的使用增加,对通风支持和无otropic 药物的需求减少;住院时间和ICU入院也减少了.
结论:
- 这项研究表明,随着时间的推移,JIR队列中MIS-C的疾病进展较为缓慢.
- 增加皮质类固醇的使用和潜在的SARS-CoV-2变异可能解释了观察到的改善.
- 这些发现凸显了MIS-C的动态性质和适应性临床管理策略的影响.
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