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10.1186/s13054-020-03332-4

http://scihub22266oqcxt.onion/10.1186/s13054-020-03332-4
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33243303!7689392!33243303
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suck abstract from ncbi


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pmid33243303      Crit+Care 2020 ; 24 (1): 666
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  • Severe manifestations of SARS-CoV-2 in children and adolescents: from COVID-19 pneumonia to multisystem inflammatory syndrome: a multicentre study in pediatric intensive care units in Spain #MMPMID33243303
  • Garcia-Salido A; de Carlos Vicente JC; Belda Hofheinz S; Balcells Ramirez J; Slocker Barrio M; Leoz Gordillo I; Hernandez Yuste A; Guitart Pardellans C; Cuervas-Mons Tejedor M; Huidobro Labarga B; Vazquez Martinez JL; Gutierrez Jimeno M; Oulego-Erroz I; Trastoy Quintela J; Medina Monzon C; Medina Ramos L; Holanda Pena MS; Gil-Anton J; Sorribes Orti C; Flores Gonzalez JC; Hernandez Palomo RM; Sanchez Ganfornina I; Fernandez Romero E; Garcia-Besteiro M; Lopez-Herce Cid J; Gonzalez Cortes R
  • Crit Care 2020[Nov]; 24 (1): 666 PMID33243303show ga
  • BACKGROUND: Multisystem inflammatory syndrome temporally associated with COVID-19 (MIS-C) has been described as a novel and often severe presentation of SARS-CoV-2 infection in children. We aimed to describe the characteristics of children admitted to Pediatric Intensive Care Units (PICUs) presenting with MIS-C in comparison with those admitted with SARS-CoV-2 infection with other features such as COVID-19 pneumonia. METHODS: A multicentric prospective national registry including 47 PICUs was carried out. Data from children admitted with confirmed SARS-CoV-2 infection or fulfilling MIS-C criteria (with or without SARS-CoV-2 PCR confirmation) were collected. Clinical, laboratory and therapeutic features between MIS-C and non-MIS-C patients were compared. RESULTS: Seventy-four children were recruited. Sixty-one percent met MIS-C definition. MIS-C patients were older than non-MIS-C patients (p = 0.002): 9.4 years (IQR 5.5-11.8) vs 3.4 years (IQR 0.4-9.4). A higher proportion of them had no previous medical history of interest (88.2% vs 51.7%, p = 0.005). Non-MIS-C patients presented more frequently with respiratory distress (60.7% vs 13.3%, p < 0.001). MIS-C patients showed higher prevalence of fever (95.6% vs 64.3%, p < 0.001), diarrhea (66.7% vs 11.5%, p < 0.001), vomits (71.1% vs 23.1%, p = 0.001), fatigue (65.9% vs 36%, p = 0.016), shock (84.4% vs 13.8%, p < 0.001) and cardiac dysfunction (53.3% vs 10.3%, p = 0.001). MIS-C group had a lower lymphocyte count (p < 0.001) and LDH (p = 0.001) but higher neutrophil count (p = 0.045), neutrophil/lymphocyte ratio (p < 0.001), C-reactive protein (p < 0.001) and procalcitonin (p < 0.001). Patients in the MIS-C group were less likely to receive invasive ventilation (13.3% vs 41.4%, p = 0.005) but were more often treated with vasoactive drugs (66.7% vs 24.1%, p < 0.001), corticosteroids (80% vs 44.8%, p = 0.003) and immunoglobulins (51.1% vs 6.9%, p < 0.001). Most patients were discharged from PICU by the end of data collection with a median length of stay of 5 days (IQR 2.5-8 days) in the MIS-C group. Three patients died, none of them belonged to the MIS-C group. CONCLUSIONS: MIS-C seems to be the most frequent presentation among critically ill children with SARS-CoV-2 infection. MIS-C patients are older and usually healthy. They show a higher prevalence of gastrointestinal symptoms and shock and are more likely to receive vasoactive drugs and immunomodulators and less likely to need mechanical ventilation than non-MIS-C patients.
  • |Adolescent[MESH]
  • |COVID-19/*epidemiology[MESH]
  • |Child[MESH]
  • |Child, Preschool[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Intensive Care Units, Pediatric[MESH]
  • |Male[MESH]
  • |Pandemics[MESH]
  • |Pneumonia, Viral/*epidemiology[MESH]
  • |Prospective Studies[MESH]
  • |Registries[MESH]
  • |SARS-CoV-2[MESH]
  • |Spain/epidemiology[MESH]


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