Population-based study of multisystem inflammatory syndrome associated with COVID-19 found that 36% of children had persistent symptoms

被引:22
作者
Kahn, Robin [1 ,2 ]
Berg, Stefan [3 ,4 ]
Berntson, Lillemor [5 ]
Berthold, Elisabet [6 ]
Brodin, Petter [7 ,8 ,9 ]
Backstrom, Fredrik [10 ]
Compagno, Michele [6 ,11 ]
Fasth, Anders [4 ]
Framme, Jenny Lingman [4 ,12 ]
Horne, AnnaCarin [8 ,9 ]
Hattting, Josefin [13 ]
Krol, Petra [1 ]
Kukka, Antti J. [5 ,14 ]
Mossberg, Maria [1 ]
Mansson, Bengt [6 ]
Nordenhall, Charlotta [15 ]
Nordstrom, Selma Idring [16 ,17 ,18 ]
Nystrom, Fatine Khammari [9 ,19 ]
Palmblad, Karin [8 ,9 ]
Rasti, Reza [9 ,20 ,21 ]
Rudolph, Andre [22 ,23 ]
Rydenman, Karin [4 ,24 ]
Sundberg, Erik [8 ,9 ]
Save-Soderbergh, Eva [25 ]
Altman, Maria [9 ,19 ]
机构
[1] Lund Univ, Dept Paediat, Clin Sci Lund, BMC B13,Klin Gatan 26, SE-22185 Lund, Sweden
[2] Lund Univ, Wallenberg Ctr Mol Med, Lund, Sweden
[3] Queen Silvia Childrens Hosp, Paediat Rheumatol, Gothenburg, Sweden
[4] Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Paediat, Gothenburg, Sweden
[5] Uppsala Univ, Dept Womens & Childrens Hlth, Uppsala, Sweden
[6] Lund Univ, Inst Clin Sci Lund, Dept Rheumatol, Lund, Sweden
[7] Karolinska Inst, Dept Womens & Childrens Hlth, Sci Life Lab, Stockholm, Sweden
[8] Karolinska Inst, Dept Womens & Childrens Hlth, Stockholm, Sweden
[9] Astrid Lindgren Childrens Hosp, Dept Paediat Rheumatol, Karolinska, Sweden
[10] Umea Univ Hosp, Dept Paediat, Umea, Sweden
[11] Lund Univ, Inst Clin Sci Malmo, Dept Rheumatol, Lund, Sweden
[12] Halland Hosp Halmstad, Dept Paediat, Region Halland, Sweden
[13] Skaraborg Hosp, Paediat Clin, Lidkoping, Sweden
[14] Dept Paediat, Gavle, Sweden
[15] Sachs Children & Youth Hosp, Stockholm, Sweden
[16] Ctr Psychiat Res, Dept Clin Neurosci, Region Stockholm, Sweden
[17] Karolinska Inst, Child & Adolescent Psychiat Res Ctr, Stockholm, Sweden
[18] Stockholm Healthcare Serv, Stockholm, Sweden
[19] Karolinska Inst, Dept Med Solna, Clin Epidemiol Unit, Stockholm, Sweden
[20] Karolinska Inst, Dept Global Publ Hlth, Stockholm, Sweden
[21] CAP Res Ctr, Stockholm Hlth Care Serv, Paediat Immunopsychiat Unit, Region Stockholm, Sweden
[22] Karolinska Univ Hosp, Paediat Heart Ctr Stockholm Uppsala, Stockholm, Sweden
[23] Karolinska Inst, Dept Med, Stockholm, Sweden
[24] NU Hosp Grp, Paediat Clin, Uddevalla, Sweden
[25] Sunderby Sjukhus, Paediat Clin, Lulea, Sweden
关键词
abnormal echocardiograms; fatigue; intensive care; outcomes; persistent symptoms;
D O I
10.1111/apa.16191
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Aim Our aim was to describe the outcomes of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19. Methods This national, population-based, longitudinal, multicentre study used Swedish data that were prospectively collected between 1 December 2020 and 31 May 2021. All patients met the World Health Organization criteria for MIS-C. The outcomes 2 and 8 weeks after diagnosis are presented, and follow-up protocols are suggested. Results We identified 152 cases, and 133 (87%) participated. When followed up 2 weeks after MIS-C was diagnosed, 43% of the 119 patients had abnormal results, including complete blood cell counts, platelet counts, albumin levels, electrocardiograms and echocardiograms. After 8 weeks, 36% of 89 had an abnormal patient history, but clinical findings were uncommon. Echocardiogram results were abnormal in 5% of 67, and the most common complaint was fatigue. Older children and those who received intensive care were more likely to report symptoms and have abnormal cardiac results. Conclusion More than a third (36%) of the patients had persistent symptoms 8 weeks after MIS-C, and 5% had abnormal echocardiograms. Older age and higher levels of initial care appeared to be risk factors. Structured follow-up visits are important after MIS-C.
引用
收藏
页码:354 / 362
页数:9
相关论文
共 18 条
[1]   Multisystem inflammatory syndrome in children: A systematic review [J].
Ahmed, Mubbasheer ;
Advani, Shailesh ;
Moreira, Axel ;
Zoretic, Sarah ;
Martinez, John ;
Chorath, Kevin ;
Acosta, Sebastian ;
Naqvi, Rija ;
Burmeister-Morton, Finn ;
Burmeister, Fiona ;
Tarriela, Aina ;
Petershack, Matthew ;
Evans, Mary ;
Hoang, Ansel ;
Rajasekaran, Karthik ;
Ahuja, Sunil ;
Moreira, Alvaro .
ECLINICALMEDICINE, 2020, 26
[2]   Review of Cardiac Involvement in Multisystem Inflammatory Syndrome in Children [J].
Alsaied, Tarek ;
Tremoulet, Adriana H. ;
Burns, Jane C. ;
Saidi, Arwa ;
Dionne, Audrey ;
Lang, Sean M. ;
Newburger, Jane W. ;
de Ferranti, Sarah ;
Friedman, Kevin G. .
CIRCULATION, 2021, 143 (01) :78-88
[3]  
Evans Claire, 2021, Paediatr Child Health (Oxford), V31, P110, DOI 10.1016/j.paed.2020.12.003
[4]   Longitudinal Outcomes for Multisystem Inflammatory Syndrome in Children [J].
Farooqi, Kanwal M. ;
Chan, Angela ;
Weller, Rachel J. ;
Mi, Junhui ;
Jiang, Pengfei ;
Abrahams, Elizabeth ;
Ferris, Anne ;
Krishnan, Usha S. ;
Pasumarti, Nikhil ;
Suh, Sanghee ;
Shah, Amee M. ;
DiLorenzo, Michael P. ;
Zachariah, Philip ;
Milner, Joshua D. ;
Rosenzweig, Erika B. ;
Gorelik, Mark ;
Anderson, Brett R. .
PEDIATRICS, 2021, 148 (02)
[5]   Characteristics and Outcomes of US Children and Adolescents With Multisystem Inflammatory Syndrome in Children (MIS-C) Compared With Severe Acute COVID-19 [J].
Feldstein, Leora R. ;
Tenforde, Mark W. ;
Friedman, Kevin G. ;
Newhams, Margaret ;
Rose, Erica Billig ;
Dapul, Heda ;
Soma, Vijaya L. ;
Maddux, Aline B. ;
Mourani, Peter M. ;
Bowens, Cindy ;
Maamari, Mia ;
Hall, Mark W. ;
Riggs, Becky J. ;
Giuliano, John S., Jr. ;
Singh, Aalok R. ;
Li, Simon ;
Kong, Michele ;
Schuster, Jennifer E. ;
McLaughlin, Gwenn E. ;
Schwartz, Stephanie P. ;
Walker, Tracie C. ;
Loftis, Laura L. ;
Hobbs, Charlotte V. ;
Halasa, Natasha B. ;
Doymaz, Sule ;
Babbitt, Christopher J. ;
Hume, Janet R. ;
Gertz, Shira J. ;
Irby, Katherine ;
Clouser, Katharine N. ;
Cvijanovich, Natalie Z. ;
Bradford, Tamara T. ;
Smith, Lincoln S. ;
Heidemann, Sabrina M. ;
Zackai, Sheemon P. ;
Wellnitz, Kari ;
Nofziger, Ryan A. ;
Horwitz, Steven M. ;
Carroll, Ryan W. ;
Rowan, Courtney M. ;
Tarquinio, Keiko M. ;
Mack, Elizabeth H. ;
Fitzgerald, Julie C. ;
Coates, Bria M. ;
Jackson, Ashley M. ;
Young, Cameron C. ;
Son, Mary Beth F. ;
Patel, Manish M. ;
Newburger, Jane W. ;
Randolph, Adrienne G. .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2021, 325 (11) :1074-1087
[6]   A national consensus management pathway for paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS): results of a national Delphi process [J].
Harwood, Rachel ;
Allin, Benjamin ;
Jones, Christine E. ;
Whittaker, Elizabeth ;
Ramnarayan, Padmanabhan ;
Ramanan, Athimalaipet, V ;
Kaleem, Musa ;
Tulloh, Robert ;
Peters, Mark J. ;
Almond, Sarah ;
Davis, Peter J. ;
Levin, Michael ;
Tometzki, Andrew ;
Faust, Saul N. ;
Knight, Marian ;
Kenny, Simon .
LANCET CHILD & ADOLESCENT HEALTH, 2021, 5 (02) :133-141
[7]   American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 and Hyperinflammation in Pediatric COVID-19: Version 2 [J].
Henderson, Lauren A. ;
Canna, Scott W. ;
Friedman, Kevin G. ;
Gorelik, Mark ;
Lapidus, Sivia K. ;
Bassiri, Hamid ;
Behrens, Edward M. ;
Ferris, Anne ;
Kernan, Kate F. ;
Schulert, Grant S. ;
Seo, Philip ;
Son, Mary Beth F. ;
Tremoulet, Adriana H. ;
Yeung, Rae S. M. ;
Mudano, Amy S. ;
Turner, Amy S. ;
Karp, David R. ;
Mehta, Jay J. .
ARTHRITIS & RHEUMATOLOGY, 2021, 73 (04) :E13-E29
[8]   The Swedish personal identity number: possibilities and pitfalls in healthcare and medical research [J].
Ludvigsson, Jonas F. ;
Otterblad-Olausson, Petra ;
Pettersson, Birgitta U. ;
Ekbom, Anders .
EUROPEAN JOURNAL OF EPIDEMIOLOGY, 2009, 24 (11) :659-667
[9]   Treatment of Multisystem Inflammatory Syndrome in Children [J].
McArdle, Andrew J. ;
Vito, Ortensia ;
Patel, Harsita ;
Seaby, Eleanor G. ;
Shah, Priyen ;
Wilson, Clare ;
Broderick, Claire ;
Nijman, Ruud ;
Tremoulet, Adriana H. ;
Munblit, Daniel ;
Ulloa-Gutierrez, Rolando ;
Carter, Michael J. ;
De, Tisham ;
Hoggart, Clive ;
Whittaker, Elizabeth ;
Herberg, Jethro A. ;
Kaforou, Myrsini ;
Cunnington, Aubrey J. ;
Levin, Michael .
NEW ENGLAND JOURNAL OF MEDICINE, 2021, 385 (01) :11-22
[10]   Association of Intravenous Immunoglobulins Plus Methylprednisolone vs Immunoglobulins Alone With Course of Fever in Multisystem Inflammatory Syndrome in Children [J].
Ouldali, Naim ;
Toubiana, Julie ;
Antona, Denise ;
Javouhey, Etienne ;
Madhi, Fouad ;
Lorrot, Mathie ;
Leger, Pierre-Louis ;
Galeotti, Caroline ;
Claude, Caroline ;
Wiedemann, Arnaud ;
Lachaume, Noemie ;
Ovaert, Caroline ;
Dumortier, Morgane ;
Kahn, Jean-Emmanuel ;
Mandelcwajg, Alexis ;
Percheron, Lucas ;
Biot, Blandine ;
Bordet, Jeanne ;
Girardin, Marie-Laure ;
Yang, David Dawei ;
Grimaud, Marion ;
Oualha, Mehdi ;
Allali, Slimane ;
Bajolle, Fanny ;
Beyler, Constance ;
Meinzer, Ulrich ;
Levy, Michael ;
Paulet, Ana-Maria ;
Levy, Corinne ;
Cohen, Robert ;
Belot, Alexandre ;
Angoulvant, Francois .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2021, 325 (09) :855-864