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

Q3 Medicine

Current Treatment Options in Pediatrics Pub Date : 2021-01-01 Epub Date: 2021-05-06 DOI:10.1007/s40746-021-00224-9

Pei-Ni Jone, Melanie D Everitt

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引用次数: 0

Abstract

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.

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新冠肺炎感染儿童多系统炎症综合征的治疗

综述的目的：本综述旨在总结与 COVID-19 感染相关的儿童多系统炎症综合征（MIS-C）的已知情况：最新发现：描述了发病时间和诊断特征。心脏受累是常见现象，也是本综述的重点。心律失常、心脏传导阻滞、急性心力衰竭、休克、心功能不全和冠状动脉扩张均有报道。治疗儿童高炎症综合征的疗法包括支持性护理和调节免疫系统的药物。常见的疗法包括静脉注射免疫球蛋白、类固醇和细胞因子导向药物，尤其是肿瘤坏死因子-α阻断剂和白细胞介素受体阻断剂。诊断 MIS-C 冠状动脉受累的临界值是冠状动脉与体表的指数尺寸超过正常值（Z 值大于 2）。住院的 MIS-C 患者要接受心电图和超声心动图评估；在运动前，应由心脏病专家进行门诊评估。今后的工作需要了解与儿童急性 COVID-19 和 MIS-C 相关的心脏受累范围，并确定这些不同实体的最佳治疗目标。

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

Current Treatment Options in Pediatrics Medicine-Pediatrics, Perinatology and Child Health

CiteScore

0.60

自引率

0.00%

发文量

期刊介绍： Current Treatment Options in Pediatrics aims to review the most important, recently published research on treatment in the field of pediatrics. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of children of all ages.We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas covering all the major medical and surgical disciplines in pediatrics. Section Editors, in turn, select topics for which leading experts contribute comprehensive treatment-focused review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also occasionally provided.