Abstract:
Multisystem Inflammatory Syndrome in Children (MIS-C) is a secondary immune manifestation of COVID-19 involving multiple organ systems in the body, resulting in fever, skin rash, abdominal pain, nausea, shock, and cardiac dysfunction that often lead to hospitalization. Although many of these symptoms resolve following anti-inflammatory treatment, the long-term neurological and psychiatric sequelae of MIS-C are unknown. In this review, we will summarize two domains of the MIS-C disease course, 1) Neuroinflammation in the MIS-C brain and 2) Psychosocial disruptions resulting from stress and hospitalization. In both domains, we present existing clinical findings and hypothesize potential connections to psychiatric outcomes. This is the first review to conceptualize a holistic framework of psychiatric risk in MIS-C patients that includes neuroinflammatory and psychosocial risk factors. As cases of severe COVID-19 and MIS-C subside, it is important for clinicians to monitor outcomes in this vulnerable patient population.
摘要:
儿童多系统炎症综合征(MIS-C)是COVID-19的继发性免疫表现,涉及体内多个器官系统,导致发烧,皮疹,腹痛,恶心,震惊,和心脏功能障碍往往导致住院。尽管许多这些症状在抗炎治疗后缓解,MIS-C的长期神经和精神后遗症尚不清楚.在这次审查中,我们将总结MIS-C病程的两个领域,1)MIS-C大脑中的神经炎症和2)压力和住院引起的心理社会破坏。在这两个领域,我们提出了现有的临床发现,并假设了与精神病结局的潜在联系.这是首次对MIS-C患者精神病风险的整体框架进行概念化,其中包括神经炎症和心理社会风险因素。随着严重COVID-19和MIS-C病例的消退,对于临床医生来说,监测这一弱势患者人群的结局非常重要.