严重的COVID-19多系统炎症综合征与印度尼西亚儿童的严重登革热:一个横截面研究
Anggraini Alam1, Fina Meilyana Andriyani2, Stanza Uga Peryoga2
1Infection & Tropical Diseases Division, Department of Child Health, Faculty of Medicine, Universitas Padjadjaran-Hasan Sadikin General Hospital, Bandung, Indonesia. anggraini.alam@unpad.ac.id.
International journal of emergency medicine
|July 11, 2024
概括
区分儿童严重多系统炎症综合征 (MIS-C) 和严重登革热至关重要. 年龄的关键差异,皮疹等症状以及血小板计数,AST和D-二次数等实验室值有助于诊断.
科学领域:
- 儿科 儿科 儿科
- 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:
- 区分儿童严重多系统炎症综合征 (MIS-C) 和严重登革热在流行地区存在诊断挑战,特别是在COVID-19大流行期间.
- 这两种疾病都有重叠的症状,如发烧,多器官干扰和休克,这使得早期识别和管理变得复杂.
- 准确的区分对于适当的临床干预和患者的结果至关重要.
研究的目的:
- 在儿科患者中确定严重的MIS-C和严重的登革热之间的关键临床和实验室差异.
- 为管理发烧性疾病的临床医生提供指导,MIS-C和严重登革热之间可能存在重叠.
- 提高诊断准确度在资源有限的设置在同时流行病期间.
主要方法:
- 对18岁以下儿童的医疗记录进行了回顾性分析,这些儿童患有严重的MIS-C或严重的登革热.
- 纳入标准侧重于2020年12月至2022年7月期间入住儿科重症监护室 (PICU) 的患者.
- 使用比较和描述性统计分析来评估两组患者之间的差异.
主要成果:
- 这项研究包括17名严重登革热患者和4名严重MIS-C患者.
- 严重的MIS-C患者比严重的登革热患者 (平均6.2年) 年长 (平均11.5年) (p=0.034).
- 在皮疹 (p=0.049),非性结膜炎 (p=0.035),血小板计数 (p=0.006),AST水平 (p=0.026),D-二次数水平 (p=0.025) 和心脏异常 (100%在MIS-C和5.9%在登革热) 的存在方面观察到显著差异.
结论:
- 年龄,特定症状 (皮疹,非性结膜炎) 和实验室标记 (血小板计数,AST,D-二次体) 在区分严重的MIS-C和严重的登革热方面具有价值.
- 心脏参与是严重MIS-C的一个突出特征,与严重登革热区分开来.
- 这些发现可以帮助临床医生在这些关键儿科疾病的差异诊断.
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