对与最近的SARS-COV-2感染相关的成人多系统炎症综合征的洞察:一个病例系列
Arun Agarwal1, Rekha Jakhar2, Ambika Sharma2
1Director, Department of Internal Medicine; Corresponding Author.
The Journal of the Association of Physicians of India
|August 31, 2023
概括
成年人多系统炎症综合征 (MIS-A) 是一种严重的COVID-19后疾病,影响多个器官. 早期识别和使用IVIg和类固醇治疗可以改善老年患者的治疗结果.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 成年人多系统炎症综合征 (MIS-A) 是一种罕见但严重的2019年冠状病毒疾病 (COVID-19) 后急性并发症.
- MIS-A具有多样化的临床表现,需要高的怀疑指数,以便及时诊断和管理.
- 在MIS-A的早期干预对于减轻与COVID-19相关的潜在长期发病率和死亡率至关重要.
研究的目的:
- 介绍最近COVID-19感染后被诊断出MIS-A的七名成年患者的病例系列.
- 详细介绍这些MIS-A病例中使用的临床表现,实验室发现和治疗策略.
- 评估特定治疗干预措施的有效性,包括静脉注射免疫球蛋白 (IVIg) 和皮质类固醇.
主要方法:
- 在2021年6月至11月期间,对7名被诊断为MIS-A的患者进行了一项回顾性观察研究.
- 患者符合MIS-A的MMWR标准,并在印度COVID-19第二波后的单个单位接受治疗.
- 收集的数据包括出现症状,临床和实验室参数,管理方案和患者结果.
主要成果:
- 该研究分析了7例MIS-A病例 (6名男性,1名女性),平均年龄为65岁.
- 所有患者的COVID-19血清学呈阳性,其中一些患者先前接种了疫苗或有症状的感染;没有一个是RT-PCR阳性.
- 通常受到影响的器官包括心血管,脏,胃肠道和中枢神经系统,所有病例都表现出高炎症. 治疗涉及类固醇 (所有患者) 和IVIg (四名患者).
结论:
- MIS-A是一种与最近的SARS-CoV-2感染相关的重大,危及生命的高炎症综合征,影响成人,包括老年人中的多个器官系统.
- 对SARS-CoV-2的快速临床怀疑和诊断测试对于识别和管理MIS-A.至关重要.
- 治疗IVIg和类固醇,以及标准护理,在管理MIS-A方面似乎是有效的,可能改善结果并降低死亡率.
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