dc.contributor.author |
García-Salido, Alberto |
dc.contributor.author |
de Carlos Vicente, Juan Carlos |
dc.contributor.author |
Belda Hofheinz, Sylvia |
dc.contributor.author |
Balcells Ramírez, Joan |
dc.contributor.author |
Slöcker Barrio, María |
dc.contributor.author |
Leóz Gordillo, Inés |
dc.contributor.author |
Hernández Yuste, Alexandra |
dc.contributor.author |
Guitart Pardellans, Carmina |
dc.contributor.author |
Cuervas-Mons Tejedor, Maite |
dc.contributor.author |
Huidobro Labarga, Beatriz |
dc.contributor.author |
Vázquez Martínez, José Luís |
dc.contributor.author |
Gutiérrez Jimeno, Míriam |
dc.contributor.author |
Oulego-Erróz, Ignacio |
dc.contributor.author |
Trastoy Quintela, Javier |
dc.contributor.author |
Medina Monzón, Carmen |
dc.contributor.author |
Medina Ramos, Laura |
dc.contributor.author |
Holanda Peña, María Soledad |
dc.contributor.author |
Gil-Antón, Javier |
dc.contributor.author |
Sorribes Ortí, Clara |
dc.contributor.author |
Flores González, José Carlos |
dc.contributor.author |
Hernández Palomo, Rosa María |
dc.contributor.author |
Sánchez Ganfornina, Inma |
dc.contributor.author |
Fernández Romero, Emilia |
dc.contributor.author |
García-Besteiro, María |
dc.contributor.author |
López-Herce Cid, Jesús |
dc.contributor.author |
González Cortés, Rafael |
dc.contributor.author |
Universitat Autònoma de Barcelona |
dc.date |
2020 |
dc.identifier |
https://ddd.uab.cat/record/244129 |
dc.identifier |
urn:10.1186/s13054-020-03332-4 |
dc.identifier |
urn:oai:ddd.uab.cat:244129 |
dc.identifier |
urn:scopus_id:85096949317 |
dc.identifier |
urn:articleid:1466609Xv24p666 |
dc.identifier |
urn:pmid:33243303 |
dc.identifier |
urn:pmc-uid:7689392 |
dc.identifier |
urn:pmcid:PMC7689392 |
dc.identifier |
urn:oai:pubmedcentral.nih.gov:7689392 |
dc.format |
application/pdf |
dc.language |
eng |
dc.publisher |
|
dc.relation |
Instituto de Salud Carlos III COV20-00944 |
dc.relation |
Critical Care ; Vol. 24 (november 2020), p. 666 |
dc.rights |
open access |
dc.rights |
Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. |
dc.rights |
https://creativecommons.org/licenses/by/4.0/ |
dc.subject |
SARS-CoV-2 |
dc.subject |
Pediatric multisystem infammatory syndrome temporally associated with COVID-19 |
dc.subject |
Kawasaki disease |
dc.subject |
Toxic shock syndrome |
dc.subject |
Children |
dc.subject |
Critical care |
dc.subject |
Shock |
dc.title |
Severe manifestations of SARS-CoV-2 in children and adolescents : from COVID-19 pneumonia to multisystem inflammatory syndrome: a multicentre study in pediatric intensive care units in Spain |
dc.type |
Estudi clínic |
dc.description.abstract |
BACKGROUND: Multisystem inflammatory syndrome temporally associated with COVID-19 (MIS-C) has been described as a novel and often severe presentation of SARS-CoV-2 infection in children. We aimed to describe the characteristics of children admitted to Pediatric Intensive Care Units (PICUs) presenting with MIS-C in comparison with those admitted with SARS-CoV-2 infection with other features such as COVID-19 pneumonia. METHODS: A multicentric prospective national registry including 47 PICUs was carried out. Data from children admitted with confirmed SARS-CoV-2 infection or fulfilling MIS-C criteria (with or without SARS-CoV-2 PCR confirmation) were collected. Clinical, laboratory and therapeutic features between MIS-C and non-MIS-C patients were compared. RESULTS: Seventy-four children were recruited. Sixty-one percent met MIS-C definition. MIS-C patients were older than non-MIS-C patients (p = 0.002): 9.4 years (IQR 5.5-11.8) vs 3.4 years (IQR 0.4-9.4). A higher proportion of them had no previous medical history of interest (88.2% vs 51.7%, p = 0.005). Non-MIS-C patients presented more frequently with respiratory distress (60.7% vs 13.3%, p < 0.001). MIS-C patients showed higher prevalence of fever (95.6% vs 64.3%, p < 0.001), diarrhea (66.7% vs 11.5%, p < 0.001), vomits (71.1% vs 23.1%, p = 0.001), fatigue (65.9% vs 36%, p = 0.016), shock (84.4% vs 13.8%, p < 0.001) and cardiac dysfunction (53.3% vs 10.3%, p = 0.001). MIS-C group had a lower lymphocyte count (p < 0.001) and LDH (p = 0.001) but higher neutrophil count (p = 0.045), neutrophil/lymphocyte ratio (p < 0.001), C-reactive protein (p < 0.001) and procalcitonin (p < 0.001). Patients in the MIS-C group were less likely to receive invasive ventilation (13.3% vs 41.4%, p = 0.005) but were more often treated with vasoactive drugs (66.7% vs 24.1%, p < 0.001), corticosteroids (80% vs 44.8%, p = 0.003) and immunoglobulins (51.1% vs 6.9%, p < 0.001). Most patients were discharged from PICU by the end of data collection with a median length of stay of 5 days (IQR 2.5-8 days) in the MIS-C group. Three patients died, none of them belonged to the MIS-C group. CONCLUSIONS: MIS-C seems to be the most frequent presentation among critically ill children with SARS-CoV-2 infection. MIS-C patients are older and usually healthy. They show a higher prevalence of gastrointestinal symptoms and shock and are more likely to receive vasoactive drugs and immunomodulators and less likely to need mechanical ventilation than non-MIS-C patients. |