Management of Multisystem Inflammatory Syndrome in Children Associated with COVID-19 Infection

被引:3
作者
Jone P.-N. [1 ]
Everitt M.D. [1 ]
机构
[1] Department of Pediatrics, Pediatric Cardiology, Children’s Hospital Colorado, University of Colorado School of Medicine, 13123 East 16th Avenue, B100, Aurora, 80045, CO
关键词
Coronary dilation; Coronavirus; COVID-19; Kawasaki disease; Multisystem inflammatory syndrome;
D O I
10.1007/s40746-021-00224-9
中图分类号
学科分类号
摘要
Purpose of review: The purpose of this review is to summarize what is known about multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 infection. Recent findings: The timing of presentation and features of diagnosis are described. Cardiac involvement is common and is the focus of this review. Arrhythmias, heart block, acute heart failure, shock, cardiac dysfunction, and coronary dilation have all been reported. Therapies used to treat children with this hyperinflammation syndrome include supportive care and agents that modulate the immune system. Therapies commonly described include intravenous immunoglobulin, steroids, and cytokine-directed agents, particularly tumor necrosis factor-alpha blockade and interleukin receptor blockade. The threshold for diagnosing coronary involvement in MIS-C is coronary artery dimensions indexed to body surface that exceed the normative values (Z score >2). Those hospitalized with MIS-C are evaluated by electrocardiogram and echocardiogram; outpatient assessment by a cardiologist is indicated prior to sports clearance. Summary: The prognosis of treated MIS-C patients is good. Future work is needed to understand the scope of cardiac involvement associated with acute COVID-19 and MIS-C in children and to define the optimal therapeutic targets for these distinct entities. © 2021, This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply.
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页码:119 / 128
页数:9
相关论文
共 55 条
[1]  
Ranard L.S., Fried J.A., Abdalla M., Anstey D.E., Givens R.C., Kumaraiah D., Et al., Approach to acute cardiovascular complications in COVID-19 infection, Circ Heart Fail, 13, 7, (2020)
[2]  
Shi S., Qin M., Shen B., Cai Y., Liu T., Yang F., Et al., Association of cardiac injury with mortality in hospitalized patients with COVID-19 in Wuhan, (2020)
[3]  
Shi S., Qin M., Cai Y., Liu T., Shen B., Yang F., Et al., Characteristics and clinical significance of myocardial injury in patients with severe coronavirus disease 2019, Eur Heart J, 41, 22, pp. 2070-2079, (2020)
[4]  
Nishiga M., Wang D.W., Han Y., Lewis D.B., Wu J.C., COVID-19 and cardiovascular disease: from basic mechanisms to clinical perspectives, Nat Rev Cardiol, 17, 9, pp. 543-558, (2020)
[5]  
Long B., Brady W.J., Koyfman A., Gottlieb M., Cardiovascular complications in COVID-19, Am J Emerg Med, 38, 7, pp. 1504-1507, (2020)
[6]  
Kochav S.M., Coromilas E., Nalbandian A., Ranard L.S., Gupta A., Chung M.K., Et al., Cardiac arrhythmias in COVID-19 infection, Circ Arrhythm Electrophysiol, 13, 6, (2020)
[7]  
Szekely Y., Lichter Y., Taieb P., Banai A., Hochstadt A., Merdler I., Et al., Spectrum of cardiac manifestations in COVID-19: a systematic echocardiographic study, Circulation., 142, 4, pp. 342-353, (2020)
[8]  
Miro O., Llorens P., Jimenez S., Pinera P., Burillo-Putze G., Martin A., Et al., Frequency of five cardiovascular/hemostatic entities as primary manifestations of SARS-CoV-2 infection: Results of the UMC-19-S2, Int J Cardiol., (2021)
[9]  
Dong Y., Mo X., Hu Y., Qi X., Jiang F., Jiang Z., Et al., Epidemiology of COVID-19 among children in China, Pediatrics, 145, 6, (2020)
[10]  
Kim L., Whitaker M., O'Halloran A., Kambhampati A., Chai S.J., Reingold A., Et al., Hospitalization rates and characteristics of children aged <18 years hospitalized with laboratory-confirmed COVID-19 - COVID-NET, 14 States, March 1-July 25, 2020, MMWR Morb Mortal Wkly Rep, 69, 32, pp. 1081-1088, (2020)