Severe COVID-19 multisystem inflammatory syndrome versus severe dengue in children from Indonesia: a cross-sectional study.

IF 2 Q2 EMERGENCY MEDICINE

International Journal of Emergency Medicine Pub Date : 2024-07-11 DOI:10.1186/s12245-024-00658-6

Anggraini Alam, Fina Meilyana Andriyani, Stanza Uga Peryoga

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引用次数: 0

Abstract

Introduction: Severe multisystem inflammatory syndrome in children (MIS-C) and severe dengue are challenging to identify during the COVID-19 pandemic in dengue-endemic areas. Fever, multiorgan involvement, and shock characterize both severe MIS-C and severe dengue. Distinguishing between the two diseases is beneficial in initiating proper management.

Methods: Medical records of children < 18 years old who were hospitalized at Hasan Sadikin General Hospital's PICU between December 2020 and July 2022 with severe MIS-C or severe dengue were recorded. Differences were assessed using comparative and descriptive analyses.

Results: Seventeen severe dengue patients and 4 severe MIS-C were included. The average age of severe MIS-C was 11.5 years (SD ± 2.9, 95% CI), and that of severe dengue patients was 6.2 years (SD ± 4.4, 95% CI) (p value = 0.034, 95%). Fever and abdominal pain were the most common symptoms in both groups (p = 0.471, 95% CI). Rash (p = 0.049) and nonpurulent conjunctivitis (p = 0.035) were two symptoms with significant differences. The highest platelet count (p-value = 0.006, 95% CI), AST (p-value = 0.026, 95% CI), and D-dimer level (p-value = 0.025, 95% CI) were significantly different between the two cohorts. Cardiac abnormalities were found in all (100%) severe MIS-C patients, but only one (5.9%) in severe dengue patients.

Conclusion: Age, rash, nonpurulent conjunctivitis, platelet count, AST and D-dimer level may distinguish severe MIS-C from severe dengue fever.

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印度尼西亚儿童的严重 COVID-19 多系统炎症综合征与严重登革热：一项横断面研究。

导言：在登革热流行地区的 COVID-19 大流行期间，儿童严重多系统炎症综合征（MIS-C）和严重登革热的识别具有挑战性。发热、多器官受累和休克是严重儿童多系统炎症综合征和严重登革热的特征。区分这两种疾病有利于采取适当的治疗措施：方法：儿童病历结果：共纳入 17 名重症登革热患者和 4 名重症 MIS-C 患者。重症 MIS-C 的平均年龄为 11.5 岁（SD ± 2.9，95% CI），重症登革热患者的平均年龄为 6.2 岁（SD ± 4.4，95% CI）（P 值 = 0.034，95%）。发热和腹痛是两组患者最常见的症状（P = 0.471，95% CI）。皮疹（p = 0.049）和非化脓性结膜炎（p = 0.035）是两组差异显著的症状。两组患者的最高血小板计数（p 值 = 0.006，95% CI）、谷草转氨酶（p 值 = 0.026，95% CI）和 D-二聚体水平（p 值 = 0.025，95% CI）存在显著差异。所有（100%）重症 MIS-C 患者均发现心脏异常，而重症登革热患者中仅有一人（5.9%）发现心脏异常：结论：年龄、皮疹、非化脓性结膜炎、血小板计数、谷草转氨酶和 D-二聚体水平可将重症 MIS-C 与重症登革热区分开来。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Emergency Medicine EMERGENCY MEDICINE-

CiteScore

4.60

自引率

0.00%

发文量

审稿时长

13 weeks

期刊介绍： The aim of the journal is to bring to light the various clinical advancements and research developments attained over the world and thus help the specialty forge ahead. It is directed towards physicians and medical personnel undergoing training or working within the field of Emergency Medicine. Medical students who are interested in pursuing a career in Emergency Medicine will also benefit from the journal. This is particularly useful for trainees in countries where the specialty is still in its infancy. Disciplines covered will include interesting clinical cases, the latest evidence-based practice and research developments in Emergency medicine including emergency pediatrics.