Severe SARS-CoV-2 Infection in Children With Suspected Acute Abdomen: A Case Series From a Tertiary Hospital in Spain

Cabrero-Hernández, Marta; García-Salido, Alberto; Leoz-Gordillo, Inés; Alonso‐Cadenas, José Antonio; Gochi-Valdovinos, Ainhoa; Brabin, Anthony González; Caro-Patón, G. de Lama; Nieto-Moro, Montserrat; de-Azagra-Garde, Amelia Martínez; Serrano-González, Ana

doi:10.1097/inf.0000000000002777

Cited by 86 publications

(106 citation statements)

References 11 publications

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“…According to the French surveillance study, MIS-C might occur in fewer than two per 10 000 children [10]. Although case series of MIS-C have now been reported from the United States [5,11,12] and Europe including the UK [2,13], Spain [14], Italy [6], France [10,[15][16][17] and Switzerland [18], only a few cases have been reported from Asia [19,20]. The aim of this study was to describe the clinical and laboratory characteristics of 45 patients who met criteria for MIS-C in Iran.…”

Section: Introductionmentioning

confidence: 99%

Multisystem inflammatory syndrome associated with SARS-CoV-2 infection in 45 children: a first report from Iran

et al. 2020

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During the coronavirus disease 2019 (COVID-19) pandemic, a new phenomenon manifesting as a multisystem inflammatory syndrome in children (MIS-C) which has a similar clinical presentation to Kawasaki disease, toxic shock syndrome and severe sepsis has emerged. Although the number of MIS-C reports is increasing, rare reports in Asia is still available. To our knowledge, this study is the largest series of published MIS-C cases in Iran. We performed a retrospective study of all patients with case definition for MIS-C admitted to the three paediatric hospitals in Iran. All of these hospitals are located within the most active COVID-19 pandemic areas (Tehran, Qom and Mazandaran) in Iran. Demographic characteristics, clinical data, laboratory findings, imaging and echocardiographic findings, treatment and outcomes were collected. Between 7 March and 23 June 2020, 45 children were included in the study. The median age of children was 7 years (range between 10 months and 17 years). Common presenting symptoms include fever (91%), abdominal pain (58%), nausea/vomiting (51%), mucocutaneous rash (53%), conjunctivitis (51%) and hands and feet oedema (40%) with median duration of symptoms prior to presentation of 5 (interquartile range (IQR) 3, 7) days. Fifty-three percent of children showed lymphopaenia. Overall, the majority of cases at admission had markedly elevated inflammatory markers erythrocyte sedimentation rate (ESR) (95.5%) and C-reactive protein (CRP) (97%). Ferritin was abnormal in 11 out of 14 tested patients (73%), and it was highly elevated (>500 ng/ml) in 47% of cases. Median fibrinogen level was 210 (IQR 165, 291) mg/dl, D-dimer was 3909 (IQR 848, 4528) ng/ml and troponin was 0.6 (IQR 0.1, 26) ng/ml, respectively. Twenty out of 31 patients (64.5%) had hypoalbuminaemia. In addition, hyponatraemia was found in 64% of cases. Twenty-five patients (56%) presented with cardiac involvement and acute renal failure was observed in 13 cases (29%). Pleural, ascitic, ileitis and pericardial effusions were found in 18%, 11%, 4% and 2% of cases, respectively. In conclusion, this is a first large case series of hospitalised children who met criteria for MIS-C in Iran. There was a wide spectrum of presenting signs and symptoms; evidence of inflammation with abnormal values of CRP, ESR, D-dimer, ferritin and albumin; and multi-organ involvement.

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Section: Introductionmentioning

confidence: 99%

Multisystem inflammatory syndrome associated with SARS-CoV-2 infection in 45 children: a first report from Iran

et al. 2020

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“…Dicho fenómeno podría estar en relación con la infiltración del tejido extracelular por parte de estas células leucocitarias pertenecientes al sistema inmunitario innato 18 . Con relación a las citocinas, se puede observar elevación de la interleucina (IL)-1 en su forma soluble (IL-1-beta) e IL-6 19 , 20 , 21 .…”

Section: Pruebas Complementarias No Vinculadas a Sars-cov-2unclassified

“…La radiografía o ecografía torácica se indicarán en caso de sintomatología respiratoria o para localizar dispositivos (tubo endotraqueal o catéter central) 24 . La radiografía de tórax puede mostrar alteraciones en un elevado porcentaje de casos 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 . Se ha descrito imagen neumónica con infiltrados, condensaciones parcheadas, en vidrio esmerilado o patrón intersticial, atelectasias o derrame pleural.…”

Section: Pruebas De Imagenunclassified

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Documento español de consenso sobre diagnóstico, estabilización y tratamiento del síndrome inflamatorio multisistémico pediátrico vinculado a SARS-CoV-2 (SIM-PedS)

García-Salido¹,

Antón²,

Martínez-Pajares³

et al. 2021

Anales de Pediatría

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Se ha descrito un nuevo síndrome inflamatorio multisistémico pediátrico vinculado a SARS-CoV-2. Este cuadro presenta una expresividad clínica variable y se asocia a infección activa o reciente por SARS-CoV-2. En este documento se revisa la literatura existente por parte de un grupo multidisciplinar de especialistas pediátricos. Posteriormente, se realizan recomendaciones sobre estabilización, diagnóstico y tratamiento de este síndrome.

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“… a lower frequency of infection [ 1 ], [ 2 ], [ 3 ], [ 4 ], [ 5 ] (some, but by far not all studies were conducted during the lockdown, which is a methodological limitation); a lower average severity of disease and associated with this; a significantly lower risk of the most serious, including fatal, courses; from CoVID-19 [ 6 ], [ 7 ], [ 8 ], [ 9 ], [ 10 ], [ 11 ], [ 12 ], [ 13 ], [ 14 ], [ 15 ], [ 16 ], [ 17 ], [ 18 ], [ 19 ], [ 20 ], [ 21 ], [ 22 ], [ 23 ], [ 24 ]. …”

Section: Introductionmentioning

confidence: 99%

Measures to maintain regular operations and prevent outbreaks of SARS-CoV-2 in childcare facilities or schools under pandemic conditions and co-circulation of other respiratory pathogens

Simon¹,

Huebner

Berner

et al. 2020

GMS Hygiene and Infection Control; 15:Doc22

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Severe SARS-CoV-2 Infection in Children With Suspected Acute Abdomen: A Case Series From a Tertiary Hospital in Spain

Cited by 86 publications

References 11 publications

Multisystem inflammatory syndrome associated with SARS-CoV-2 infection in 45 children: a first report from Iran

Multisystem inflammatory syndrome associated with SARS-CoV-2 infection in 45 children: a first report from Iran

Documento español de consenso sobre diagnóstico, estabilización y tratamiento del síndrome inflamatorio multisistémico pediátrico vinculado a SARS-CoV-2 (SIM-PedS)

Measures to maintain regular operations and prevent outbreaks of SARS-CoV-2 in childcare facilities or schools under pandemic conditions and co-circulation of other respiratory pathogens

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