Multisystem inflammatory syndrome in children associated with COVID-19 in 101 cases from Turkey (Turk-MISC study)
Yazar
Bursal Duramaz, Burcu
Yakut, Nurhayat
Kilic, Ahmet Osman
Cakici, Ozlem
Kucuk, Mehmet
Kaba, Ozge
Karaoglu Asrak, Hatice
Dalkiran, Tahir
Ekemen Keles, Yildiz
Karbuz, Adem
ÇETİN, BENHUR ŞİRVAN
Elmas Bozdemir, Sefika
Kara, Ates
Berna Anil, Ayse
Turgut, Mehmet
Karapinar, Bulent
Somer, Ayper
Elmali, Ferhan
Dinleyici, Ener Cagri
Ciftci, Ergin
Yilmaz Ciftdogan, Dilek
KEPENEKLİ KADAYİFCİ, EDA
Metin Akcan, Ozge
Ozer, Arife
Erat, Tugba
Sutcu, Murat
HANÇERLİ TÖRÜN, Selda
Buyukcam, Ayse
Belet, Nursen
Erdeniz, Emine Hafize
Dalgic Karabulut, Nazan
Oncel, Selim
Orbak, Zerrin
Turel, Ozden
Gayretli Aydin, Zeynep Gokce
Kilic, Omer
Yahsi, Aysun
Kara Aksay, Ahu
Ergenc, Zeynep
Petmezci, Mey Talip
Oflaz, Mehmet Burhan
Sarikaya, Remzi
Otar Yener, Gulcin
Ozen, Seval
Gul, Doruk
Arslan, Gazi
Kara, Soner Sertan
Demirkol, Demet
Yazici Ozkaya, Pinar
Yozgat, Yilmaz
Varan, Celal
Kara, Manolya
Arga, Gul
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Aim Multisystem inflammatory syndrome in children (MIS-C) may cause shock and even death in children. The aim of this study is to describe the clinical features, laboratory characteristics and outcome of children diagnosed with MIS-C in 25 different hospitals in Turkey. Methods The retrospective study was conducted between 8 April and 28 October 2020 in 25 different hospitals from 17 cities. Data were collected from patients' medical records using a standardised form. Clinical and laboratory characteristics and outcomes according to different age groups, gender and body mass index percentiles were compared using multivariate logistic regression analysis. Results The study comprised 101 patients, median age 7 years (interquartile range (IQR) 4.6-9.3); 51 (50.5%) were boys. Reverse-transcriptase polymerase chain reaction (PCR) assay was positive in 21/100 (21%) patients; 62/83 (74.6%) patients had positive serology for SARS-CoV-2. The predominant complaints were fever (100%), fatigue (n = 90, 89.1%), and gastrointestinal symptoms (n = 81, 80.2%). Serum C-reactive protein (in 101 patients, median 165 mg/L; range 112-228), erythrocyte sedimentation rate (73/84, median 53 mm/s; IQR 30-84) and procalcitonin levels (86/89, median 5 mu g/L; IQR 0.58-20.2) were elevated. Thirty-eight patients (37.6%) required admission to intensive care. Kawasaki disease (KD) was diagnosed in 70 (69.3%) patients, 40 of whom had classical KD. Most patients were treated with intravenous immunoglobulin (n = 92, 91%) and glucocorticoids (n = 59, 58.4%). Seven patients (6.9%) died. Conclusion The clinical spectrum of MIS-C is broad, but clinicians should consider MIS-C in the differential diagnosis when persistent fever, fatigue and gastrointestinal symptoms are prominent. Most patients diagnosed with MIS-C were previously healthy. Immunomodulatory treatment and supportive intensive care are important in the management of cases with MIS-C. Glucocorticoids and intravenous immunoglobulins are the most common immunomodulatory treatment options for MIS-C. Prompt diagnosis and prompt treatment are essential for optimal management.
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- Makale [92796]