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10.1017/S095026882000196X

http://scihub22266oqcxt.onion/10.1017/S095026882000196X
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32854812!7484297!32854812
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suck abstract from ncbi


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pmid32854812      Epidemiol+Infect 2020 ; 148 (ä): e196
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  • Multisystem inflammatory syndrome associated with SARS-CoV-2 infection in 45 children: a first report from Iran #MMPMID32854812
  • Mamishi S; Movahedi Z; Mohammadi M; Ziaee V; Khodabandeh M; Abdolsalehi MR; Navaeian A; Heydari H; Mahmoudi S; Pourakbari B
  • Epidemiol Infect 2020[Aug]; 148 (ä): e196 PMID32854812show ga
  • During the coronavirus disease 2019 (COVID-19) pandemic, a new phenomenon manifesting as a multisystem inflammatory syndrome in children (MIS-C) which has a similar clinical presentation to Kawasaki disease, toxic shock syndrome and severe sepsis has emerged. Although the number of MIS-C reports is increasing, rare reports in Asia is still available. To our knowledge, this study is the largest series of published MIS-C cases in Iran. We performed a retrospective study of all patients with case definition for MIS-C admitted to the three paediatric hospitals in Iran. All of these hospitals are located within the most active COVID-19 pandemic areas (Tehran, Qom and Mazandaran) in Iran. Demographic characteristics, clinical data, laboratory findings, imaging and echocardiographic findings, treatment and outcomes were collected. Between 7 March and 23 June 2020, 45 children were included in the study. The median age of children was 7 years (range between 10 months and 17 years). Common presenting symptoms include fever (91%), abdominal pain (58%), nausea/vomiting (51%), mucocutaneous rash (53%), conjunctivitis (51%) and hands and feet oedema (40%) with median duration of symptoms prior to presentation of 5 (interquartile range (IQR) 3, 7) days. Fifty-three percent of children showed lymphopaenia. Overall, the majority of cases at admission had markedly elevated inflammatory markers erythrocyte sedimentation rate (ESR) (95.5%) and C-reactive protein (CRP) (97%). Ferritin was abnormal in 11 out of 14 tested patients (73%), and it was highly elevated (>500 ng/ml) in 47% of cases. Median fibrinogen level was 210 (IQR 165, 291) mg/dl, D-dimer was 3909 (IQR 848, 4528) ng/ml and troponin was 0.6 (IQR 0.1, 26) ng/ml, respectively. Twenty out of 31 patients (64.5%) had hypoalbuminaemia. In addition, hyponatraemia was found in 64% of cases. Twenty-five patients (56%) presented with cardiac involvement and acute renal failure was observed in 13 cases (29%). Pleural, ascitic, ileitis and pericardial effusions were found in 18%, 11%, 4% and 2% of cases, respectively. In conclusion, this is a first large case series of hospitalised children who met criteria for MIS-C in Iran. There was a wide spectrum of presenting signs and symptoms; evidence of inflammation with abnormal values of CRP, ESR, D-dimer, ferritin and albumin; and multi-organ involvement.
  • |Adolescent[MESH]
  • |COVID-19[MESH]
  • |Child[MESH]
  • |Child, Preschool[MESH]
  • |Coronavirus Infections/*complications/*epidemiology[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Infant[MESH]
  • |Iran/epidemiology[MESH]
  • |Male[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/*complications/*epidemiology[MESH]


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