COVID-19 associated multisystemic inflammatory syndrome in 614 children with and without overlap with Kawasaki disease-Turk MIS-C study group
Makaleler > Tam Makale · 2022
Yazarlar: DİLEK YILMAZ ÇİFTDOĞAN, Yildiz Ekemen Keles, BENHUR ŞİRVAN ÇETİN, Nazan Dalgic Karabulut, MELİKE EMİROĞLU, Zafer Bagci, Ayse Buyukcam, Emine Hafize Erdeniz, GÜL ARGA, Edanur Yesil, ÖZLEM ÇAKICI, Adem Karbuz, Zümrüt ŞAHBUDAK BAL, Soner Sertan Kara, Arife Ozer, ÖZGE METİN AKCAN, Sefika Elmas Bozdemir, AYŞE BERNA ANIL, Hatice Uygun, ÖMER KILIÇ, Selda Hancerli Torun, ZÜHAL ÜMİT, Murat Sutcu, Berfin Ozgokce Ozmen, HATİCE KARAOĞLU ASRAK, Gulsum Alkan, Ahu Kara Aksay, Cuneyt Ugur, Ahmet Ziya Birbilen, Burcu Bursal Duramaz, Esra Akyuz Ozkan, Ozgur Burakay, Sema Yildirim Arslan, Eda Karadag Oncel, Serkan Fazli Celik, Ahmet Osman Kilic, Seval Ozen, Remzi Sarikaya, Demet Demirkol, GAZİ ARSLAN, Özden TÜREL, AHMET SERT, Ergul Sari, Zerrin ORBAK, Irfan Oguz Sahin, Celal Varan, Hacer Akturk, Sadiye Kubra Tuter Oz, Fatih Durak, MEHMET BURHAN OFLAZ, Manolya Kara, Derya Karpuz, Mey Talip Petmezci, Nevin Hatipoglu, SELİM ÖNCEL, MEHMET TURĞUT, FERHAN ELMALI, Ayper Somer, NECDET KUYUCU, ENER ÇAĞRI DİNLEYİCİ, Nuri Zafer KURUGÖL, ERGİN ÇİFTCİ, ATEŞ KARA
European Journal of Pediatrics, SCI Expanded İndekslerine Giren Dergi, Uluslararası, Wos, 2022, cilt 181, ss 2031-2043
DOI: 10.1007/s00431-022-04390-2
Özet
Multisystemic inflammatory syndrome (MIS-C) diagnosis remains difficult because the clinical features overlap with Kawasaki disease (KD). The study aims to highlight the clinical and laboratory features and outcomes of patients with MISC whose clinical manifestations overlap with or without KD. This study is a retrospective analysis of a case series designed for patients aged 1 month to 18 years in 28 hospitals between November 1, 2020, and June 9, 2021. Patient demographics, complaints, laboratory results, echocardiographic results, system involvement, and outcomes were recorded. A total of 614 patients were enrolled; the median age was 7.4 years (interquartile range (IQR) 3.9-12 years). A total of 277 (45.1%) patients with MIS-C had manifestations that overlapped with KD, including 92 (33.3%) patients with complete KD and 185 (66.7%) with incomplete KD. Lymphocyte and platelet counts were significantly lower in patients with MISC, overlapped with KD (lymphocyte count 1080 vs. 1280 cells x mu L, p = 0.028; platelet count 166 vs. 216 cells x 10(3)/mu L, p < 0.001). The median serum procalcitonin levels were statistically higher in patients overlapped with KD (3.18 vs. 1.68 mu g/L, p = 0.001). Coronary artery dilatation was statistically significant in patients with overlap with KD (13.4% vs. 6.8%, p = 0.007), while myocarditis was significantly more common in patients without overlap with KD features (2.6% vs 7.4%, p = 0.009). The association between clinical and laboratory findings and overlap with KD was investigated. Age > 12 years reduced the risk of overlap with KD by 66% (p < 0.001, 95% CI 0.217-0.550), lethargy increased the risk of overlap with KD by 2.6-fold (p = 0.011, 95% CI 1.244-5.439), and each unit more albumin (g/dl) reduced the risk of overlap with KD by 60% (p < 0.001, 95% CI 0.298-0.559).