No abstract

No abstract

Background: Multisystem inflammatory syndrome temporally associated with COVID-19 presents with similar symptomatology and therapeutic approach to Kawasaki disease in the pediatric population. Given the novelty of the disease and the growing scientific literature on the subject, it is relevant to collect and report available scientific information. This review aimed to explore the medical evidence on multisystem inflammatory syndrome temporally associated with COVID-19 in a population under 18 years of age. Methods: We conducted a scoping review using Scopus and PubMed, including observational (cohort, case-control, and cross-sectional) studies and case series. Results: Of the total articles reviewed as of April 10, 2021, 45 articles met eligibility criteria: case series (n = 32), retrospective cohort studies (n = 6), prospective cohort studies (n = 4), case-control studies (n = 2), and cross-sectional studies (n = 1). Gastrointestinal and respiratory symptoms and myocardial dysfunction are the most commonly reported. The most relevant paraclinical markers were lymphopenia, thrombocytopenia, and elevated D-dimer levels. Conclusions: The multisystem inflammatory syndrome temporally associated with COVID-19 presents a broad spectrum of signs and symptoms. Aneurysms of the coronary arteries and myocarditis are usually present in the acute phases of the disease. The early diagnosis led by a multidisciplinary group of pediatric intensivists, infectious disease specialists, cardiologists, and rheumatologists allows adequate and effective medical management.

A lo largo de la historia, el ser humano ha utilizado plantas para prevenir, aliviar y curar enfermedades. Cabe destacar que durante mucho tiempo se desconoció el mecanismo por el cual su uso era beneficioso, lo que hacía de la fitoterapia una ciencia netamente empírica. Las recetas médicas eran consideradas un avance médico significativo, resultado de conocimientos y prácticas traídas desde el viejo continente.

BackgroundThe ROX index (Respiratory rate-OXygenation) has been described as a prediction tool to identify the need for invasive mechanical ventilation (IMV) in community-acquired pneumonia (CAP) with acute hypoxaemic respiratory failure treated with high-flow nasal cannula in order to avoid delay of a necessary intubation. However, its use in predicting the need for ventilatory support in hospitalised patients with CAP has not been validated.MethodsThis is a retrospective cohort study including subjects with CAP treated in the general ward, emergency service or intensive care unit of a third-level centre in Cundinamarca, Colombia, between January 2001 and February 2020. The ROX index was estimated as the ratio of oxygen saturation/fraction of inspired oxygen to respiratory rate.ResultsA total of 895 patients were included, of whom 93 (10%) required IMV. The ROX index proved to be a good predictor, presenting an area under the curve of receiver operating characteristics (AUROC) of 0.733 (95% CI 0.671 to 0.795, p<0.001) when determined by pulse oximetry and an AUROC of 0.779 (95% CI 0.699 to 0.859, p<0.001) when estimated by arterial blood gas (ABG) parameters, with an intraclass correlation of 0.894. The estimated cut-off point was 14.8; a score less than 14.8 indicates high risk of requiring IMV.ConclusionThe ROX index is a good predictor of IMV in hospitalised patients with CAP. It presents good performance when calculated through pulse oximetry and can replace the one calculated by ABG.