دورية أكاديمية
Clinical manifestations and risk factors of shock in children with multisystem inflammatory syndrome.
| العنوان: | Clinical manifestations and risk factors of shock in children with multisystem inflammatory syndrome. |
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| المؤلفون: | Wu CH; Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan., Chang TH; Department of Pediatrics, Chi-Mei Medical Center, Tainan, Taiwan., Tan BF; Department of Pediatrics, National Taiwan University Hospital, Hsin-Chu Branch, Taiwan., Wu JL; Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan., Huang SM; Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan., Yen TY; Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan., Wu ET; Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan., Wang CC; Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan., Lin MT; Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan., Lu CY; Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: cylu@ntu.edu.tw., Chang LY; Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: lychang@ntu.edu.tw., Huang LM; Department of Pediatrics, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan. |
| المصدر: | Journal of the Formosan Medical Association = Taiwan yi zhi [J Formos Med Assoc] 2024 Apr; Vol. 123 (4), pp. 496-500. Date of Electronic Publication: 2023 Oct 29. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Formosan Medical Association, Elsevier Country of Publication: Singapore NLM ID: 9214933 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 0929-6646 (Print) Linking ISSN: 09296646 NLM ISO Abbreviation: J Formos Med Assoc Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2003- : Singapore : Formosan Medical Association, Elsevier Original Publication: Taipei, Taiwan : Formosan Medical Association, [1991- |
| مواضيع طبية MeSH: | COVID-19*/*complications, Pneumonia, Viral*/epidemiology , COVID-19*/epidemiology , Systemic Inflammatory Response Syndrome*, Child ; Humans ; Procalcitonin ; C-Reactive Protein/analysis ; Retrospective Studies |
| مستخلص: | Background: Multisystem inflammatory syndrome in children (MIS-C) is a novel disease associated with COVID-19. The COVID-19 epidemic peaked in May 2022 in Taiwan, and we encountered our first case of MIS-C in late May 2022. We aimed to present patients' clinical manifestations and identify risk factors for shock. Methods: We included patients diagnosed with MIS-C at two medical centers from May 2022 to August 2022. We separated those patients into two groups according to whether they experienced shock. We collected demographic, clinical manifestation, and laboratory data of the patients and performed statistical analysis between the two groups. Results: We enrolled 28 patients, including 13 (46 %) with shock and 15 (54 %) without shock. The median age was 6.4 years (IQR: 1.9-7.5). In single variable analysis, patients with shock tended to be older, had more neurological symptoms, more conjunctivitis and strawberry tongue, lower lymphocyte count, lower platelet counts, and higher C-reactive protein, higher procalcitonin, higher ferritin, and higher D-dimer levels than those without shock. The area under the ROC curve that used procalcitonin to be the risk factor of shock with MIS-C was 0.815 (95 % CI 0.644 to 0.987). The cutoff value obtained by ROC analysis of procalcitonin was 1.68 ng/mL. With this cutoff, the test characteristics of procalcitonin were as follows: sensitivity 77 %, specificity 93 %, positive predictive value 91 %, negative predictive value 82 %. Multivariable analysis revealed that procalcitonin was the only independent risk factor of shock with MIS-C on admission (OR, 26.00, 95 % CI, 1.01-668.89). Conclusions: MIS-C patients with high initial procalcitonin levels have higher risks of experiencing shock and may need ICU admission. Competing Interests: Declaration of competing interest The authors have no conflicts of interest relevant to this article. (Copyright © 2023, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).) |
| فهرسة مساهمة: | Keywords: COVID-19; MIS-C; Procalcitonin; Risk factor; Shock |
| المشرفين على المادة: | 0 (Procalcitonin) 9007-41-4 (C-Reactive Protein) |
| SCR Disease Name: | pediatric multisystem inflammatory disease, COVID-19 related |
| تواريخ الأحداث: | Date Created: 20231030 Date Completed: 20240415 Latest Revision: 20240415 |
| رمز التحديث: | 20240415 |
| DOI: | 10.1016/j.jfma.2023.10.002 |
| PMID: | 37903693 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 0929-6646 |
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| DOI: | 10.1016/j.jfma.2023.10.002 |