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Multisystem inflammatory syndrome in children during the COVID-19 pandemic in Turkey: first report from the Eastern Mediterranean
OBJECTIVE: We aimed to describe the typical clinical and laboratory features and treatment of children diagnosed with multisystem inflammatory syndrome in children (MIS-C) and to understand the differences as compared to severe/critical pediatric cases with COVID-19 in an eastern Mediterranean count...
Autores principales: | , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879406/ https://www.ncbi.nlm.nih.gov/pubmed/33576926 http://dx.doi.org/10.1007/s10067-021-05631-9 |
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author | Ozsurekci, Yasemin Gürlevik, Sibel Kesici, Selman Akca, Ummusen Kaya Oygar, Pembe Derin Aykac, Kubra Karacanoglu, Dilek Sarıtas Nakip, Ozlem Ilbay, Sare Katlan, Ban Ertugrul, İlker Cengiz, Ali Bülent Basaran, Ozge Cura Yayla, Burcu Ceylan Karakaya, Jale Bilginer, Yelda Bayrakci, Benan Ceyhan, Mehmet Ozen, Seza |
author_facet | Ozsurekci, Yasemin Gürlevik, Sibel Kesici, Selman Akca, Ummusen Kaya Oygar, Pembe Derin Aykac, Kubra Karacanoglu, Dilek Sarıtas Nakip, Ozlem Ilbay, Sare Katlan, Ban Ertugrul, İlker Cengiz, Ali Bülent Basaran, Ozge Cura Yayla, Burcu Ceylan Karakaya, Jale Bilginer, Yelda Bayrakci, Benan Ceyhan, Mehmet Ozen, Seza |
author_sort | Ozsurekci, Yasemin |
collection | PubMed |
description | OBJECTIVE: We aimed to describe the typical clinical and laboratory features and treatment of children diagnosed with multisystem inflammatory syndrome in children (MIS-C) and to understand the differences as compared to severe/critical pediatric cases with COVID-19 in an eastern Mediterranean country. METHODS: Children (aged <18 years) who diagnosed with MIS-C and severe/critical pediatric cases with COVID-19 and were admitted to hospital between March 26 and November 3, 2020 were enrolled in the study. RESULTS: A total of 52 patients, 22 patients diagnosed with COVID-19 with severe/critical disease course and 30 patients diagnosed with MIS-C, were included in the study. Although severe COVID-19 cases and cases with MIS-C share many clinical and laboratory features, MIS-C cases had longer fever duration and higher rate of the existence of rash, conjunctival injection, peripheral edema, abdominal pain, altered mental status, and myalgia than in severe cases (p<0.001 for each). Of all, 53.3% of MIS-C cases had the evidence of myocardial involvement as compared to severe cases (27.2%). Additionally, C-reactive protein (CRP) and white blood cell (WBC) are the independent predictors for the diagnosis of MIS-C, particularly in the existence of conjunctival injection and rash. Corticosteroids, intravenous immunoglobulin (IVIG), and biologic immunomodulatory treatments were mainly used in MIS-C cases rather than cases with severe disease course. There were only three deaths among 52 patients, one of whom had Burkitt lymphoma and the two cases with severe COVID-19 of late referral. CONCLUSION: Differences between clinical presentations, acute phase responses, organ involvements, and management strategies indicate that MIS-C might be a distinct immunopathogenic disease as compared to pediatric COVID-19. Conjunctival injection and higher CRP and low WBC count are reliable diagnostic parameters for MIS-C cases. |
format | Online Article Text |
id | pubmed-7879406 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-78794062021-02-16 Multisystem inflammatory syndrome in children during the COVID-19 pandemic in Turkey: first report from the Eastern Mediterranean Ozsurekci, Yasemin Gürlevik, Sibel Kesici, Selman Akca, Ummusen Kaya Oygar, Pembe Derin Aykac, Kubra Karacanoglu, Dilek Sarıtas Nakip, Ozlem Ilbay, Sare Katlan, Ban Ertugrul, İlker Cengiz, Ali Bülent Basaran, Ozge Cura Yayla, Burcu Ceylan Karakaya, Jale Bilginer, Yelda Bayrakci, Benan Ceyhan, Mehmet Ozen, Seza Clin Rheumatol Original Article OBJECTIVE: We aimed to describe the typical clinical and laboratory features and treatment of children diagnosed with multisystem inflammatory syndrome in children (MIS-C) and to understand the differences as compared to severe/critical pediatric cases with COVID-19 in an eastern Mediterranean country. METHODS: Children (aged <18 years) who diagnosed with MIS-C and severe/critical pediatric cases with COVID-19 and were admitted to hospital between March 26 and November 3, 2020 were enrolled in the study. RESULTS: A total of 52 patients, 22 patients diagnosed with COVID-19 with severe/critical disease course and 30 patients diagnosed with MIS-C, were included in the study. Although severe COVID-19 cases and cases with MIS-C share many clinical and laboratory features, MIS-C cases had longer fever duration and higher rate of the existence of rash, conjunctival injection, peripheral edema, abdominal pain, altered mental status, and myalgia than in severe cases (p<0.001 for each). Of all, 53.3% of MIS-C cases had the evidence of myocardial involvement as compared to severe cases (27.2%). Additionally, C-reactive protein (CRP) and white blood cell (WBC) are the independent predictors for the diagnosis of MIS-C, particularly in the existence of conjunctival injection and rash. Corticosteroids, intravenous immunoglobulin (IVIG), and biologic immunomodulatory treatments were mainly used in MIS-C cases rather than cases with severe disease course. There were only three deaths among 52 patients, one of whom had Burkitt lymphoma and the two cases with severe COVID-19 of late referral. CONCLUSION: Differences between clinical presentations, acute phase responses, organ involvements, and management strategies indicate that MIS-C might be a distinct immunopathogenic disease as compared to pediatric COVID-19. Conjunctival injection and higher CRP and low WBC count are reliable diagnostic parameters for MIS-C cases. Springer International Publishing 2021-02-12 2021 /pmc/articles/PMC7879406/ /pubmed/33576926 http://dx.doi.org/10.1007/s10067-021-05631-9 Text en © International League of Associations for Rheumatology (ILAR) 2021, corrected publication 2021 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. |
spellingShingle | Original Article Ozsurekci, Yasemin Gürlevik, Sibel Kesici, Selman Akca, Ummusen Kaya Oygar, Pembe Derin Aykac, Kubra Karacanoglu, Dilek Sarıtas Nakip, Ozlem Ilbay, Sare Katlan, Ban Ertugrul, İlker Cengiz, Ali Bülent Basaran, Ozge Cura Yayla, Burcu Ceylan Karakaya, Jale Bilginer, Yelda Bayrakci, Benan Ceyhan, Mehmet Ozen, Seza Multisystem inflammatory syndrome in children during the COVID-19 pandemic in Turkey: first report from the Eastern Mediterranean |
title | Multisystem inflammatory syndrome in children during the COVID-19 pandemic in Turkey: first report from the Eastern Mediterranean |
title_full | Multisystem inflammatory syndrome in children during the COVID-19 pandemic in Turkey: first report from the Eastern Mediterranean |
title_fullStr | Multisystem inflammatory syndrome in children during the COVID-19 pandemic in Turkey: first report from the Eastern Mediterranean |
title_full_unstemmed | Multisystem inflammatory syndrome in children during the COVID-19 pandemic in Turkey: first report from the Eastern Mediterranean |
title_short | Multisystem inflammatory syndrome in children during the COVID-19 pandemic in Turkey: first report from the Eastern Mediterranean |
title_sort | multisystem inflammatory syndrome in children during the covid-19 pandemic in turkey: first report from the eastern mediterranean |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7879406/ https://www.ncbi.nlm.nih.gov/pubmed/33576926 http://dx.doi.org/10.1007/s10067-021-05631-9 |
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