Multisystem pediatric inflammatory syndrome associated with COVID-2019 in the Zaporizhzhia region
DOI:
https://doi.org/10.14739/2310-1237.2023.3.286445Keywords:
viral infection, COVID-19, multisystem inflammatory syndrome in children, children, complications, diagnosticsAbstract
The aim is to familiarize with the clinical signs of the multisystem inflammatory syndrome associated with COVID-19, based on the analysis of its course in children of the Zaporizhzhia region of Ukraine.
Materials and methods. A retrospective analysis of the medical histories of 16 children, aged from 1 to 16 years, who had a history of COVID-19 and/or who were in contact with patients with this disease and had a confirmed disease accompanied by fever, disorders of other organs and systems, was conducted.
The methods of non-parametric statistics – descriptive statistics and statistical inference – were used for statistical processing of the results. All calculations were carried out using Microsoft Excel.
Results. Symptoms found in the examined children met the following WHO diagnostic criteria for multisystem pediatric inflammatory syndrome associated with COVID-2019: the age ranged from 1 to 16 years. Fever lasting at least 3 days was observed in 100 % of the subjects. Evidence of multisystem disease occurred in all patients in particular: 8 children had tiny-dotted exanthema, 12 – pharyngitis; damage to the cardiovascular system in the form of cardiopathy was detected in 12 children, rhythm disorders in 15, dysmetabolic changes in the myocardium in 9; laboratory signs of coagulopathy in the form of an increased level of D-dimer were observed in 8 children, a decrease in thrombin time in 4; abdominal syndrome was found in 8 children. All patients had elevated levels of inflammatory markers. During the examinations, no convincing evidence of the presence of another disease that could cause these symptoms was found.
All children had evidence of infection with the SARS-CoV-2 virus, namely, 9 had a history of COVID-19, 2 had a positive PCR test, 12 had IgG to COVID-19, and 5 had IgM to COVID-19.
Conclusions. The article demonstrates the polymorphism of the clinical and laboratory manifestations of the multisystem pediatric inflammatory syndrome associated with COVID-2019; easy to use WHO criteria WHO criteria for diagnosing this syndrome; the need for every physician to be alert to this syndrome when in contact with a child who has fever for three or more days during the period of epidemic disorder due to coronavirus disease (COVID-19).
References
Oshlyanska, O. A., Okhotnikova, O. M., Zakharchuk, O. V., & Rusak, S. O. (2021). Multysystemnyi zapalnyi syndrom, asotsiiovanyi z infektsiieiu SARS-CoV-2, u ditei: nova khvoroba chy syndrom? Na prykladi klinichnoho vypadku [Multisystem inflammatory syndrome associated with SARS-CoV-2 infection in children: new disease or syndrome? On the example of a clinical case]. Ukrainian Journal of Rheumatology, (2), 1-10. [in Ukrainian]. https://doi.org/10.32471/rheumatology.2707-6970.84.16258
Potehina, T. (2020). Kavasaki-podibni symptomy v ditei z COVID‑19: pediatrychnyi multysystemnyi zapalnyi syndrom [Kawasaki-like symptoms in children with COVID-19: pediatric multisystem inflammatory syndrome]. Dytiachyi likar, (2), 21-24. [in Ukrainian].
Tuikkala, H. (2021). Multysystemnyi zapalnyi syndrom u ditei (MIS-C), poviazanyi z infektsiieiu COVID-19 [Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 infection]. [in Ukrainian]. https://www.dec.gov.ua/wp-content/uploads/2022/01/multysystemnyj-zapalnyj-syndrom-u-ditej-mis-c-covid-19.pdf
Ministry of Health of Ukraine. (2021). Klinichne vedennia patsiientiv z COVID-19 «ZhYVA» klinichna nastanova (KN 2021-762) [Clinical management of patients with COVID-19 "ZHYVA" clinical guidelines (KN 2021-762)]. Retrieved from https://www.dec.gov.ua/wp-content/uploads/2021/04/2021_04_kn_covid-19.pdf
Usachova, O. V., Konakova, O. V., Silina, Y. A., & Vorobiova, N. V. (2022). Multysystemnyi zapalnyi syndrom, imovirno, asotsiiovanyi iz SARS-CoV-2, uskladnenyi utvorenniam trombu v pravomu peredserdi, u dytyny (klinichnyi vypadok) [Multisystem inflammatory syndrome, probably associated with SARS-CoV-2, complicated by thrombus in the right atrium, in a child]. Pathologia, 19(2), 146-153. https://doi.org/10.14739/2310-1237.2022.2.255603
Henderson, L. A., Canna, S. W., Friedman, K. G., Gorelik, M., Lapidus, S. K., Bassiri, H., Behrens, E. M., Ferris, A., Kernan, K. F., Schulert, G. S., Seo, P., Son, M. B. F., Tremoulet, A. H., Yeung, R. S. M., Mudano, A. S., Turner, A. S., Karp, D. R., & Mehta, J. J. (2021). American College of Rheumatology Clinical Guidance for Multisystem Inflammatory Syndrome in Children Associated With SARS-CoV-2 and Hyperinflammation in Pediatric COVID-19: Version 2. Arthritis & rheumatology (Hoboken, N.J.), 73(4), e13-e29. https://doi.org/10.1002/art.41616
Verdoni, L., Mazza, A., Gervasoni, A., Martelli, L., Ruggeri, M., Ciuffreda, M., Bonanomi, E., & D'Antiga, L. (2020). An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet (London, England), 395(10239), 1771-1778. https://doi.org/10.1016/S0140-6736(20)31103-X
Riphagen, S., Gomez, X., Gonzalez-Martinez, C., Wilkinson, N., & Theocharis, P. (2020). Hyperinflammatory shock in children during COVID-19 pandemic. Lancet (London, England), 395(10237), 1607-1608. https://doi.org/10.1016/S0140-6736(20)31094-1
Health Policy team. (2020). Paediatric multisystem inflammatory syndrome temporally associated with covid-19 (PIMS) - guidance for clinicians. RCPCH. Retrieved from https://www.rcpch.ac.uk/resources/paediatric-multisystem-inflammatory-syndrome-temporally-associated-covid-19-pims-guidance
Media & Public Affairs team. (2020, May 1). Leading paediatricians publish case definition for illness affecting children during COVID-19. RCPCH. Retrieved from https://www.rcpch.ac.uk/news-events/news/leading-paediatricians-publish-case-definition-illness-affecting-children-during
World Health Organization. (2020, May 15). Multisystem inflammatory syndrome in children and adolescents temporally related to COVID-19. Retrieved from https://www.who.int/news-room/commentaries/detail/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19
Belot, A., Antona, D., Renolleau, S., Javouhey, E., Hentgen, V., Angoulvant, F., Delacourt, C., Iriart, X., Ovaert, C., Bader-Meunier, B., Kone-Paut, I., & Levy-Bruhl, D. (2020). SARS-CoV-2-related paediatric inflammatory multisystem syndrome, an epidemiological study, France, 1 March to 17 May 2020. European communicable disease bulletin, 25(22), 2001010. https://doi.org/10.2807/1560-7917.ES.2020.25.22.2001010
Stasiak, A., Perdas, E., & Smolewska, E. (2022). Risk factors of a severe course of pediatric multi-system inflammatory syndrome temporally associated with COVID-19. European journal of pediatrics, 181(10), 3733-3738. https://doi.org/10.1007/s00431-022-04584-8
Flood, J., Shingleton, J., Bennett, E., Walker, B., Amin-Chowdhury, Z., Oligbu, G., Avis, J., Lynn, R. M., Davis, P., Bharucha, T., Pain, C. E., Jyothish, D., Whittaker, E., Dwarakanathan, B., Wood, R., Williams, C., Swann, O., Semple, M. G., Ramsay, M. E., Jones, C. E., … Ladhani, S. N. (2021). Paediatric multisystem inflammatory syndrome temporally associated with SARS-CoV-2 (PIMS-TS): Prospective, national surveillance, United Kingdom and Ireland, 2020. The Lancet regional health. Europe, 3, 100075. https://doi.org/10.1016/j.lanepe.2021.100075
Chen, M. R., Kuo, H. C., Lee, Y. J., Chi, H., Li, S. C., Lee, H. C., & Yang, K. D. (2021). Phenotype, Susceptibility, Autoimmunity, and Immunotherapy Between Kawasaki Disease and Coronavirus Disease-19 Associated Multisystem Inflammatory Syndrome in Children. Frontiers in immunology, 12, 632890. https://doi.org/10.3389/fimmu.2021.632890
Stierman, B., Abrams, J. Y., Godfred-Cato, S. E., Oster, M. E., Meng, L., Yip, L., Patel, P., Balachandran, N., Prezzato, E., Pierce, T., Hsu, K. K., Burns, M., Peterson Pompa, X., Lauro, P., Hartley, A., Jones, C., Gretsch, S., Reid, H., Lim, S., Campbell, A. P., … Belay, E. D. (2021). Racial and Ethnic Disparities in Multisystem Inflammatory Syndrome in Children in the United States, March 2020 to February 2021. The Pediatric infectious disease journal, 40(11), e400-e406. https://doi.org/10.1097/INF.0000000000003294
Zhang, Q. Y., Xu, B. W., & Du, J. B. (2021). Similarities and differences between multiple inflammatory syndrome in children associated with COVID-19 and Kawasaki disease: clinical presentations, diagnosis, and treatment. World journal of pediatrics : WJP, 17(4), 335-340. https://doi.org/10.1007/s12519-021-00435-y
Raab, C. P. (2023). Kawasaki disease. MSD Manual Professional Version. Retrieved from https://www.msdmanuals.com/professional/pediatrics/miscellaneous-disorders-in-infants-and-children/kawasaki-disease
Jiang, L., Tang, K., Irfan, O., Li, X., Zhang, E., & Bhutta, Z. (2022). Epidemiology, Clinical Features, and Outcomes of Multisystem Inflammatory Syndrome in Children (MIS-C) and Adolescents-a Live Systematic Review and Meta-analysis. Current pediatrics reports, 10(2), 19-30. https://doi.org/10.1007/s40124-022-00264-1
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