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10.1016/S2352-4642(21)00050-X http://scihub22266oqcxt.onion/10.1016/S2352-4642(21)00050-X 33711293!7943393!33711293     free     free     free Warning: file_get_contents(https://eutils.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&id=33711293&cmd=llinks): Failed to open stream: HTTP request failed! 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Factors linked to severe outcomes in multisystem inflammatory syndrome in children (MIS-C) in the USA: a retrospective surveillance study |pdf=|usr=}}{{33711293}} gab.com Text Factors linked to severe outcomes in multisystem inflammatory syndrome in children (MIS-C) in the USA: a retrospective surveillance study JO: Lancet Child Adolesc Health http://www.kidney.de/pget.php?&tw=1&pmid=33711293 #FOAvip BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a newly identified and serious health condition associated with SARS-CoV-2 infection. Clinical manifestations vary widely among patients with MIS-C, and the aim of this study was to investigate factors associated with severe outcomes. METHODS: In this retrospective surveillance study, patients who met the US Centers for Disease Control and Prevention (CDC) case definition for MIS-C (younger than 21 years, fever, laboratory evidence of inflammation, admitted to hospital, multisystem [>/=2] organ involvement [cardiac, renal, respiratory, haematological, gastrointestinal, dermatological, or neurological], no alternative plausible diagnosis, and either laboratory confirmation of SARS-CoV-2 infection by RT-PCR, serology, or antigen test, or known COVID-19 exposure within 4 weeks before symptom onset) were reported from state and local health departments to the CDC using standard case-report forms. Factors assessed for potential links to severe outcomes included pre-existing patient factors (sex, age, race or ethnicity, obesity, and MIS-C symptom onset date before June 1, 2020) and clinical findings (signs or symptoms and laboratory markers). Logistic regression models, adjusted for all pre-existing factors, were used to estimate odds ratios between potential explanatory factors and the following outcomes: intensive care unit (ICU) admission, shock, decreased cardiac function, myocarditis, and coronary artery abnormalities. FINDINGS: 1080 patients met the CDC case definition for MIS-C and had symptom onset between March 11 and Oct 10, 2020. ICU admission was more likely in patients aged 6-12 years (adjusted odds ratio 1.9 [95% CI 1.4-2.6) and patients aged 13-20 years (2.6 [1.8-3.8]), compared with patients aged 0-5 years, and more likely in non-Hispanic Black patients, compared with non-Hispanic White patients (1.6 [1.0-2.4]). ICU admission was more likely for patients with shortness of breath (1.9 [1.2-2.9]), abdominal pain (1.7 [1.2-2.7]), and patients with increased concentrations of C-reactive protein, troponin, ferritin, D-dimer, brain natriuretic peptide (BNP), N-terminal pro B-type BNP, or interleukin-6, or reduced platelet or lymphocyte counts. We found similar associations for decreased cardiac function, shock, and myocarditis. Coronary artery abnormalities were more common in male patients (1.5 [1.1-2.1]) than in female patients and patients with mucocutaneous lesions (2.2 [1.3-3.5]) or conjunctival injection (2.3 [1.4-3.7]). INTERPRETATION: Identification of important demographic and clinical characteristics could aid in early recognition and prompt management of severe outcomes for patients with MIS-C. FUNDING: None. Twit Text FOAVip Factors linked to severe outcomes in multisystem inflammatory syndrome in children (MIS-C) in the USA: a retrospective surveillance study ????Lancet Child Adolesc Health http://www.kidney.de/pget.php?&tw=1&pmid=33711293 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=33711293 #FOAvip English Wikipedia <ref>{{Cite pmid|33711293}}</ref> Factors linked to severe outcomes in multisystem inflammatory syndrome in children (MIS-C) in the USA: a retrospective surveillance study #MMPMID33711293 Abrams JY; Oster ME; Godfred-Cato SE; Bryant B; Datta SD; Campbell AP; Leung JW; Tsang CA; Pierce TJ; Kennedy JL; Hammett TA; Belay ED Lancet Child Adolesc Health 2021[May]; 5 (5): 323-331 PMID33711293show ga BACKGROUND: Multisystem inflammatory syndrome in children (MIS-C) is a newly identified and serious health condition associated with SARS-CoV-2 infection. Clinical manifestations vary widely among patients with MIS-C, and the aim of this study was to investigate factors associated with severe outcomes. METHODS: In this retrospective surveillance study, patients who met the US Centers for Disease Control and Prevention (CDC) case definition for MIS-C (younger than 21 years, fever, laboratory evidence of inflammation, admitted to hospital, multisystem [>/=2] organ involvement [cardiac, renal, respiratory, haematological, gastrointestinal, dermatological, or neurological], no alternative plausible diagnosis, and either laboratory confirmation of SARS-CoV-2 infection by RT-PCR, serology, or antigen test, or known COVID-19 exposure within 4 weeks before symptom onset) were reported from state and local health departments to the CDC using standard case-report forms. Factors assessed for potential links to severe outcomes included pre-existing patient factors (sex, age, race or ethnicity, obesity, and MIS-C symptom onset date before June 1, 2020) and clinical findings (signs or symptoms and laboratory markers). Logistic regression models, adjusted for all pre-existing factors, were used to estimate odds ratios between potential explanatory factors and the following outcomes: intensive care unit (ICU) admission, shock, decreased cardiac function, myocarditis, and coronary artery abnormalities. FINDINGS: 1080 patients met the CDC case definition for MIS-C and had symptom onset between March 11 and Oct 10, 2020. ICU admission was more likely in patients aged 6-12 years (adjusted odds ratio 1.9 [95% CI 1.4-2.6) and patients aged 13-20 years (2.6 [1.8-3.8]), compared with patients aged 0-5 years, and more likely in non-Hispanic Black patients, compared with non-Hispanic White patients (1.6 [1.0-2.4]). ICU admission was more likely for patients with shortness of breath (1.9 [1.2-2.9]), abdominal pain (1.7 [1.2-2.7]), and patients with increased concentrations of C-reactive protein, troponin, ferritin, D-dimer, brain natriuretic peptide (BNP), N-terminal pro B-type BNP, or interleukin-6, or reduced platelet or lymphocyte counts. We found similar associations for decreased cardiac function, shock, and myocarditis. Coronary artery abnormalities were more common in male patients (1.5 [1.1-2.1]) than in female patients and patients with mucocutaneous lesions (2.2 [1.3-3.5]) or conjunctival injection (2.3 [1.4-3.7]). INTERPRETATION: Identification of important demographic and clinical characteristics could aid in early recognition and prompt management of severe outcomes for patients with MIS-C. FUNDING: None. |Adolescent[MESH] |Biomarkers/blood[MESH] |COVID-19/*complications/diagnosis/epidemiology/*therapy[MESH] |Child[MESH] |Child, Preschool[MESH] |Critical Care[MESH] |Early Diagnosis[MESH] |Ethnicity[MESH] |Female[MESH] |Humans[MESH] |Infant[MESH] |Infant, Newborn[MESH] |Male[MESH] |Retrospective Studies[MESH] |Risk Factors[MESH] |Systemic Inflammatory Response Syndrome/*complications/diagnosis/epidemiology/*therapy[MESH] |Time-to-Treatment[MESH] |Treatment Outcome[MESH] |United States[MESH]Factors linked to severe outcomes in multisystem inflammatory syndrome(epmc).pdf DeepDyve Pubget Overpricing