需要机械通风的COVID-19成人多系统炎症综合征:一个回顾性队列研究
Fumito Kato1, Naofumi Bunya1,2, Ryuichi Nakayama1
1Department of Emergency Medicine Sapporo Medical University Sapporo Japan.
Acute medicine & surgery
|August 28, 2023
概括
成年人多系统炎症综合征 (MIS-A) 影响2.5%的危急COVID-19患者,通常在最初感染后几周出现. 这种情况与更高的ECMO使用和更低的生存率有关.
科学领域:
- 关键护理医学 关键护理医学
- 传染性疾病 传染性疾病
- 免疫学 免疫学 免疫学
背景情况:
- 成年人多系统炎症综合征 (MIS-A) 是一种与COVID-19相关的严重过度炎症状况.
- 将MIS-A与COVID-19进展区分开来是具有挑战性的,因为器官损伤和炎症等症状重叠.
研究的目的:
- 在重症COVID-19患者中调查MIS-A的特征和并发症.
- 在重症监护机构中识别与MIS-A相关的因素.
主要方法:
- 在日本使用CRISIS数据库对危急COVID-19患者的回顾性分析 (2020年3月至2021年12月).
- 根据年龄 (≥18岁),实验室炎症,≥2个肺外器官的严重功能障碍和排除其他原因来定义MIS-A.
主要成果:
- 在危急的COVID-19患者中,2.5% (26/1052) 被诊断为MIS-A.
- 与非MIS-A患者相比,MIS-A患者的ECMO使用率 (46%vs. 13%) 和生存率 (42%vs. 77%) 显著提高,而非MIS-A患者的生存率则降低.
- 超过80%的MIS-A病例在COVID-19最初发病后超过三周后表现出来.
结论:
- MIS-A发生在很少但很大比例的重症COVID-19患者中,与不良结果相关.
- 在COVID-19后的几周内,在患有不明原因的复发性炎症和多器官功能障碍的患者中考虑MIS-A.
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