{"title":"SARS-CoV-2 大流行期间川崎病与儿童多系统炎症综合征的比较。","authors":"Tunç Tunçer, Fatih Varol","doi":"10.3390/children11101185","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>The purpose of this study was to compare and contrast Kawasaki disease (KD) with multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic.</p><p><strong>Methods: </strong>A retrospective analysis of the medical records of patients diagnosed with KD and MIS-C at a single institution from July 2020 to November 2021 was performed.</p><p><strong>Results: </strong>The study included 39 MIS-C patients (84.6% male) with a median age of 138 months and 17 KD patients (58.8% male) with a median age of 36 months. The MIS-C patients were older (<i>p</i> < 0.001) and had prolonged hospitalizations (<i>p</i> = 0.023), elevated neutrophil counts (<i>p</i> < 0.001), C-reactive protein (<i>p</i> < 0.001), procalcitonin (<i>p</i> < 0.001), interleukin-6 (<i>p</i> < 0.014), ferritin (<i>p</i> < 0.001), fibrinogen (<i>p</i> < 0.001), troponin I (<i>p</i> = 0.001), NT-proBNP (<i>p</i> < 0.001), and D-dimer levels (<i>p</i> < 0.001). There were more cases of hypotension (<i>p</i> = 0.024), decreased left ventricular function (<i>p</i> = 0.023), and a greater need for corticosteroids (<i>p</i> < 0.001), enoxaparin (<i>p</i> = 0.045), and therapeutic plasma exchange (<i>p</i> < 0.001). Kawasaki disease patients had a greater incidence of rash (<i>p</i> < 0.001), changes in oral mucosa (<i>p</i> < 0.001), conjunctival injection (<i>p</i> < 0.001), extremity changes (<i>p</i> < 0.001), and cervical lymphadenopathy (<i>p</i> < 0.001). They had a longer duration of fever (<i>p</i> < 0.001), elevated white blood cell count (<i>p</i> < 0.001), platelet count (<i>p</i> < 0.001), and alanine aminotransferase level (<i>p</i> < 0.001). The two groups were similar regarding the hemoglobin levels, erythrocyte sedimentation rates, albumin levels, and the frequency of coronary aneurysm, myocarditis, pericarditis, invasive mechanical ventilatory support, and intravenous immunoglobulin treatment.</p><p><strong>Conclusions: </strong>Advanced patient age, a greater presence of gastrointestinal and cardiac findings associated with hypotension, increased NT-proBNP levels, decreased left ventricular function, the use of various treatment modalities, and longer hospital stays suggest MIS-C, whereas prolonged fever and classical clinical features of KD favor KD.</p>","PeriodicalId":48588,"journal":{"name":"Children-Basel","volume":null,"pages":null},"PeriodicalIF":2.0000,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11505943/pdf/","citationCount":"0","resultStr":"{\"title\":\"A Comparison of Kawasaki Disease during the SARS-CoV-2 Pandemic with Multisystem Inflammatory Syndrome in Children.\",\"authors\":\"Tunç Tunçer, Fatih Varol\",\"doi\":\"10.3390/children11101185\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>The purpose of this study was to compare and contrast Kawasaki disease (KD) with multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic.</p><p><strong>Methods: </strong>A retrospective analysis of the medical records of patients diagnosed with KD and MIS-C at a single institution from July 2020 to November 2021 was performed.</p><p><strong>Results: </strong>The study included 39 MIS-C patients (84.6% male) with a median age of 138 months and 17 KD patients (58.8% male) with a median age of 36 months. The MIS-C patients were older (<i>p</i> < 0.001) and had prolonged hospitalizations (<i>p</i> = 0.023), elevated neutrophil counts (<i>p</i> < 0.001), C-reactive protein (<i>p</i> < 0.001), procalcitonin (<i>p</i> < 0.001), interleukin-6 (<i>p</i> < 0.014), ferritin (<i>p</i> < 0.001), fibrinogen (<i>p</i> < 0.001), troponin I (<i>p</i> = 0.001), NT-proBNP (<i>p</i> < 0.001), and D-dimer levels (<i>p</i> < 0.001). There were more cases of hypotension (<i>p</i> = 0.024), decreased left ventricular function (<i>p</i> = 0.023), and a greater need for corticosteroids (<i>p</i> < 0.001), enoxaparin (<i>p</i> = 0.045), and therapeutic plasma exchange (<i>p</i> < 0.001). Kawasaki disease patients had a greater incidence of rash (<i>p</i> < 0.001), changes in oral mucosa (<i>p</i> < 0.001), conjunctival injection (<i>p</i> < 0.001), extremity changes (<i>p</i> < 0.001), and cervical lymphadenopathy (<i>p</i> < 0.001). They had a longer duration of fever (<i>p</i> < 0.001), elevated white blood cell count (<i>p</i> < 0.001), platelet count (<i>p</i> < 0.001), and alanine aminotransferase level (<i>p</i> < 0.001). The two groups were similar regarding the hemoglobin levels, erythrocyte sedimentation rates, albumin levels, and the frequency of coronary aneurysm, myocarditis, pericarditis, invasive mechanical ventilatory support, and intravenous immunoglobulin treatment.</p><p><strong>Conclusions: </strong>Advanced patient age, a greater presence of gastrointestinal and cardiac findings associated with hypotension, increased NT-proBNP levels, decreased left ventricular function, the use of various treatment modalities, and longer hospital stays suggest MIS-C, whereas prolonged fever and classical clinical features of KD favor KD.</p>\",\"PeriodicalId\":48588,\"journal\":{\"name\":\"Children-Basel\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-09-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11505943/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Children-Basel\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3390/children11101185\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Children-Basel","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3390/children11101185","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PEDIATRICS","Score":null,"Total":0}
A Comparison of Kawasaki Disease during the SARS-CoV-2 Pandemic with Multisystem Inflammatory Syndrome in Children.
Objectives: The purpose of this study was to compare and contrast Kawasaki disease (KD) with multisystem inflammatory syndrome in children (MIS-C) during the SARS-CoV-2 pandemic.
Methods: A retrospective analysis of the medical records of patients diagnosed with KD and MIS-C at a single institution from July 2020 to November 2021 was performed.
Results: The study included 39 MIS-C patients (84.6% male) with a median age of 138 months and 17 KD patients (58.8% male) with a median age of 36 months. The MIS-C patients were older (p < 0.001) and had prolonged hospitalizations (p = 0.023), elevated neutrophil counts (p < 0.001), C-reactive protein (p < 0.001), procalcitonin (p < 0.001), interleukin-6 (p < 0.014), ferritin (p < 0.001), fibrinogen (p < 0.001), troponin I (p = 0.001), NT-proBNP (p < 0.001), and D-dimer levels (p < 0.001). There were more cases of hypotension (p = 0.024), decreased left ventricular function (p = 0.023), and a greater need for corticosteroids (p < 0.001), enoxaparin (p = 0.045), and therapeutic plasma exchange (p < 0.001). Kawasaki disease patients had a greater incidence of rash (p < 0.001), changes in oral mucosa (p < 0.001), conjunctival injection (p < 0.001), extremity changes (p < 0.001), and cervical lymphadenopathy (p < 0.001). They had a longer duration of fever (p < 0.001), elevated white blood cell count (p < 0.001), platelet count (p < 0.001), and alanine aminotransferase level (p < 0.001). The two groups were similar regarding the hemoglobin levels, erythrocyte sedimentation rates, albumin levels, and the frequency of coronary aneurysm, myocarditis, pericarditis, invasive mechanical ventilatory support, and intravenous immunoglobulin treatment.
Conclusions: Advanced patient age, a greater presence of gastrointestinal and cardiac findings associated with hypotension, increased NT-proBNP levels, decreased left ventricular function, the use of various treatment modalities, and longer hospital stays suggest MIS-C, whereas prolonged fever and classical clinical features of KD favor KD.
期刊介绍:
Children is an international, open access journal dedicated to a streamlined, yet scientifically rigorous, dissemination of peer-reviewed science related to childhood health and disease in developed and developing countries.
The publication focuses on sharing clinical, epidemiological and translational science relevant to children’s health. Moreover, the primary goals of the publication are to highlight under‑represented pediatric disciplines, to emphasize interdisciplinary research and to disseminate advances in knowledge in global child health. In addition to original research, the journal publishes expert editorials and commentaries, clinical case reports, and insightful communications reflecting the latest developments in pediatric medicine. By publishing meritorious articles as soon as the editorial review process is completed, rather than at predefined intervals, Children also permits rapid open access sharing of new information, allowing us to reach the broadest audience in the most expedient fashion.