儿童多系统炎症综合征(MIS-C)是与2019年冠状病毒病(COVID-19)相关的一种相对较新的综合征,与小儿COVID-19相比,其特征是严重的临床病程。这篇综述旨在收集关于COVID-19儿童MIS-C临床表现和管理的现有证据。在这次系统审查中,在以下数据库中进行了全面搜索:PubMed,Embase,Medline,谷歌学者,科克伦,还有Scopus,使用预定的搜索条件,例如医学主题词(MeSH)和关键字,以查找有关MIS-C的相关研究。提取相关数据,并使用合适的方法评估研究的质量。在研究中对收集到的研究结果进行了综合和讨论。世界卫生组织(WHO)对MIS-C的定义因其精确性和包容性而最受青睐。MIS-C主要影响6-12岁儿童,男性占主导地位。MIS-C涉及一系列系统,包括胃肠,心血管,血液学,粘膜皮肤,和呼吸。影像学检查结果显示心血管异常,实性内脏器官受累,和肠道异常,反映了全身性炎症过程。实验室调查揭示了炎症标志物升高,中性粒细胞激活,血管中细胞外陷阱的释放,降钙素原升高,低钠血症,低蛋白血症,低血红蛋白,和血小板减少症.炎症标志物和自身抗体谱对于区分MIS-C和COVID-19至关重要。优选的治疗主要包括免疫调节疗法,如静脉注射免疫球蛋白(IVIG),糖皮质激素,和白介素-6或1RA抑制剂或它们的组合。在严重的情况下,体外膜氧合(ECMO)和机械通气是必要的,导致死亡率降低和快速恢复。这项审查发现,平均住院时间为7天,大多数出院儿童在七天内完全康复。MIS-C是一种危及生命的COVID-19后疾病,由于全身性炎症而涉及多个系统,炎症标志物升高。识别多系统参与至关重要,及时识别和多学科治疗对于最佳结果至关重要。
Multisystem inflammatory syndrome in children (MIS-C) is a relatively new syndrome associated with coronavirus disease 2019 (COVID-19) that is characterized by a severe clinical course compared to pediatric COVID-19. This review aimed to compile the available evidence on the clinical presentation and management of MIS-C in children with COVID-19. During this systematic review, a comprehensive search was performed in the following databases: PubMed, Embase, Medline, Google Scholar, Cochrane, and Scopus, using predetermined search terms, such as Medical Subject Headings (MeSH) and keywords to find relevant studies on the MIS-C. Relevant data were extracted, and the quality of the studies was evaluated using suitable methods. The collected findings were synthesized and discussed in the study. The World Health Organization\'s (WHO) definition of MIS-C was the most favored due to its precision and inclusiveness. MIS-C primarily affected children aged 6-12 years, with male predominance. MIS-C involves a range of systems, including gastrointestinal, cardiovascular, hematologic, mucocutaneous, and respiratory. Radiographic findings revealed cardiovascular abnormalities, solid visceral organ involvement, and bowel abnormalities, reflecting a systemic inflammatory process. Laboratory investigations unveiled elevated inflammatory markers, neutrophil activation, release of extracellular traps in vessels, elevated procalcitonin, hyponatremia, hypoalbuminemia, low hemoglobin, and thrombocytopenia. The inflammatory markers and autoantibody profiles are essential in differentiating MIS-C from COVID-19. The preferred treatment primarily involves immunomodulatory therapies like intravenous immunoglobulin (IVIG), glucocorticoids, and interleukin-6 or 1RA inhibitors or a combination of those. In severe cases, extracorporeal membrane oxygenation (ECMO) and mechanical ventilation are necessary, leading to reduced mortality and quick recovery. This review found that the average hospital stay was seven days, and most discharged children fully recovered within seven days. MIS-C is a life-threatening post-COVID-19 condition and involves multiple systems due to systemic inflammation, with elevated inflammation markers. Recognition of multisystem involvement is crucial, and prompt identification and multidisciplinary treatment are vital for optimal outcomes.