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10.1016/j.jpeds.2020.10.013

http://scihub22266oqcxt.onion/10.1016/j.jpeds.2020.10.013
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33065115!7553071!33065115
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suck abstract from ncbi


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pmid33065115      J+Pediatr 2021 ; 229 (ä): 26-32.e2
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  • Discriminating Multisystem Inflammatory Syndrome in Children Requiring Treatment from Common Febrile Conditions in Outpatient Settings #MMPMID33065115
  • Carlin RF; Fischer AM; Pitkowsky Z; Abel D; Sewell TB; Landau EG; Caddle S; Robbins-Milne L; Boneparth A; Milner JD; Cheung EW; Zachariah P; Stockwell MS; Anderson BR; Gorelik M
  • J Pediatr 2021[Feb]; 229 (ä): 26-32.e2 PMID33065115show ga
  • OBJECTIVES: To examine whether patients with multisystem inflammatory syndrome in children (MIS-C) demonstrated well-defined clinical features distinct from other febrile outpatients, given the difficulties of seeing acute care visits during the severe acute respiratory syndrome coronavirus 2 pandemic and the risks associated with both over- and underdiagnosis of MIS-C. STUDY DESIGN: This case-controlled study compared patients diagnosed with and treated for MIS-C at a large urban children's hospital with patients evaluated for fever at outpatient acute care visits during the peak period of MIS-C. Symptomatology and available objective data were extracted. Comparisons were performed using t tests with corrections for multiple comparisons, and multivariable logistic regression to obtain ORs. RESULTS: We identified 44 patients with MIS-C between April 16 and June 10, 2020. During the same period, 181 pediatric patients were evaluated for febrile illnesses in participating outpatient clinics. Patients with MIS-C reported greater median maximum reported temperature height (40 degrees C vs 38.9, P < .0001), and increased frequency of abdominal pain (OR 12.5, 95% CI [1.65-33.24]), neck pain (536.5, [2.23-129,029]), conjunctivitis (31.3, [4.6-212.8]), oral mucosal irritation (11.8, [1.4-99.4]), extremity swelling or rash (99.9, [5-1960]), and generalized rash (7.42, [1.6-33.2]). Patients with MIS-C demonstrated lower absolute lymphocyte (P < .0001) and platelet counts (P < .05) and greater C-reactive protein concentrations (P < .001). CONCLUSIONS: Patients treated for MIS-C due to concern for potential cardiac injury show combinations of features distinct from other febrile patients seen in outpatient clinics during the same period.
  • |*Ambulatory Care[MESH]
  • |Adolescent[MESH]
  • |Age Factors[MESH]
  • |COVID-19/*complications/*diagnosis/therapy[MESH]
  • |Child[MESH]
  • |Child, Preschool[MESH]
  • |Diagnosis, Differential[MESH]
  • |Female[MESH]
  • |Fever/*diagnosis/*etiology[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Retrospective Studies[MESH]
  • |Symptom Assessment[MESH]


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