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10.1097/PEC.0000000000002248

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32970023!8555855!32970023
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suck abstract from ncbi


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pmid32970023      Pediatr+Emerg+Care 2020 ; 36 (11): 554-558
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  • Distinguishing Multisystem Inflammatory Syndrome in Children From Kawasaki Disease and Benign Inflammatory Illnesses in the SARS-CoV-2 Pandemic #MMPMID32970023
  • Corwin DJ; Sartori LF; Chiotos K; Odom John AR; Cohn K; Bassiri H; Behrens EM; Teachey DT; Henrickson SE; Diorio CJ; Zorc JJ; Balamuth F
  • Pediatr Emerg Care 2020[Nov]; 36 (11): 554-558 PMID32970023show ga
  • OBJECTIVE: The aim of the study was to compare presenting clinical and laboratory features among children meeting the surveillance definition for multisystem inflammatory syndrome in children (MIS-C) across a range of illness severities. METHODS: This is a retrospective single-center study of patients younger than 21 years presenting between March 1 and May 15, 2020. Included patients met the Centers for Disease Control and Prevention criteria for MIS-C (inflammation, fever, involvement of 2 organ systems, lack of alternative diagnoses). We defined 3 subgroups by clinical outcomes: (1) critical illness requiring intensive care interventions; (2) patients meeting Kawasaki disease (KD) criteria but not requiring critical care; and (3) mild illness not meeting either criteria. A comparator cohort included patients with KD at our institution during the same time frame in 2019. RESULTS: Thirty-three patients were included (5, critical; 8, 2020 KD; 20, mild). The median age for the critical group was 10.9 years (2.7 for 2020 KD; 6.0 for mild, P = 0.033). The critical group had lower median absolute lymphocyte count (850 vs 3005 vs 2940/uL, P = 0.005), platelets (150 vs 361 vs 252 k/uL, P = 0.005), and sodium (129 vs 136 vs 136 mmol/L, P = 0.002), and higher creatinine (0.7 vs 0.2 vs 0.3 mg/dL, P = 0.002). In the critical group, 60% required vasoactive medications, and 40% required mechanical ventilation. Clinical and laboratories features were similar between the 2020 and 2019 KD groups. CONCLUSIONS: We describe 3 groups with inflammatory syndromes during the SARS-CoV-2 pandemic. The initial profile of lymphopenia, thrombocytopenia, hyponatremia, and abnormal creatinine may help distinguish critically ill MIS-C patients from classic/atypical KD or more benign acute inflammation.
  • |*Betacoronavirus[MESH]
  • |*Disease Management[MESH]
  • |*Pandemics[MESH]
  • |Adolescent[MESH]
  • |COVID-19[MESH]
  • |Child[MESH]
  • |Coronavirus Infections/*diagnosis/epidemiology/therapy[MESH]
  • |Critical Care/*methods[MESH]
  • |Diagnosis, Differential[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Mucocutaneous Lymph Node Syndrome/*diagnosis[MESH]
  • |Pneumonia, Viral/*diagnosis/epidemiology/therapy[MESH]
  • |Retrospective Studies[MESH]


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