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《JAMA，6月8日，Multisystem Inflammatory Syndrome Related to COVID-19 in Previously Healthy Children and Adolescents in New York City》

  • 来源专题：COVID-19科研动态监测
  • 编译者： xuwenwhlib
  • 发布时间：2020-06-09

  • Multisystem Inflammatory Syndrome Related to COVID-19 in Previously Healthy Children and Adolescents in New York City
    Eva W. Cheung, MD1; Philip Zachariah, MD, MS1; Mark Gorelik, MD1; et alAlexis Boneparth, MD1; Steven G. Kernie, MD1; Jordan S. Orange, MD, PhD1; Joshua D. Milner, MD1
    Author Affiliations Article Information
    JAMA. Published online June 8, 2020. doi:10.1001/jama.2020.10374

    Patients were included if they (1) were 21 years or younger; (2) were hospitalized at Columbia University Irving Medical Center/NewYork-Presbyterian Morgan Stanley Children’s Hospital in New York City between April 18 and May 5, 2020; (3) presented with a clinical syndrome characterized by prolonged fever, systemic inflammation, shock, end-organ dysfunction, or symptoms reminiscent of KD or TSS; and (4) had evidence of recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. SARS-CoV-2 infection was determined by reverse transcriptase–polymerase chain reaction (RT-PCR) of nasopharyngeal swabs or positive serology. Serology testing was done using a New York State Department of Health–approved combined assay for IgM and IgG antibodies against SARS-CoV-2 spike trimer or nucleocapsid protein (96% specificity, 93% sensitivity). Admission testing included hematologic parameters, chemistries, co-infections, and inflammatory markers along with assessments of cardiac function (electrocardiograms, transthoracic echocardiograms). The Columbia University ethics committee approved the study with a waiver of informed consent.

  • 原文来源：https://jamanetwork.com/journals/jama/fullarticle/2767207
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    • 来源专题：COVID-19科研动态监测
    • 编译者：zhangmin
    • 发布时间：2020-06-30
    • Multisystem Inflammatory Syndrome in U.S. Children and Adolescents List of authors. Leora R. Feldstein, Ph.D., Erica B. Rose, Ph.D., Steven M. Horwitz, M.D., Jennifer P. Collins, M.D., Margaret M. Newhams, M.P.H., Mary Beth F. Son, M.D., Jane W. Newburger, M.D., M.P.H., Lawrence C. Kleinman, M.D., M.P.H., Sabrina M. Heidemann, M.D., Amarilis A. Martin, M.D., Aalok R. Singh, M.D., Simon Li, M.D., M.P.H., et al., for the Overcoming COVID-19 Investigators, and the CDC COVID-19 Response Team* Abstract BACKGROUND Understanding the epidemiology and clinical course of multisystem inflammatory syndrome in children (MIS-C) and its temporal association with coronavirus disease 2019 (Covid-19) is important, given the clinical and public health implications of the syndrome. METHODS We conducted targeted surveillance for MIS-C from March 15 to May 20, 2020, in pediatric health centers across the United States. The case definition included six criteria: serious illness leading to hospitalization, an age of less than 21 years, fever that lasted for at least 24 hours, laboratory evidence of inflammation, multisystem organ involvement, and evidence of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on reverse-transcriptase polymerase chain reaction (RT-PCR), antibody testing, or exposure to persons with Covid-19 in the past month. Clinicians abstracted the data onto standardized forms.
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  • 《BMJ，6月3日，Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study》
    • 来源专题：COVID-19科研动态监测
    • 编译者：xuwenwhlib
    • 发布时间：2020-06-05
    • Kawasaki-like multisystem inflammatory syndrome in children during the covid-19 pandemic in Paris, France: prospective observational study BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m2094 (Published 03 June 2020) Cite this as: BMJ 2020;369:m2094 Abstract Objectives To describe the characteristics of children and adolescents affected by an outbreak of Kawasaki-like multisystem inflammatory syndrome and to evaluate a potential temporal association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Design Prospective observational study. Setting General paediatric department of a university hospital in Paris, France. Participants 21 children and adolescents (aged ≤18 years) with features of Kawasaki disease who were admitted to hospital between 27 April and 11 May 2020 and followed up until discharge by 15 May 2020. Main outcome measures The primary outcomes were clinical and biological data, imaging and echocardiographic findings, treatment, and outcomes. Nasopharyngeal swabs were prospectively tested for SARS-CoV-2 using reverse transcription-polymerase chain reaction (RT-PCR) and blood samples were tested for IgG antibodies to the virus. Results 21 children and adolescents (median age 7.9 (range 3.7-16.6) years) were admitted with features of Kawasaki disease over a 15 day period, with 12 (57%) of African ancestry. 12 (57%) presented with Kawasaki disease shock syndrome and 16 (76%) with myocarditis. 17 (81%) required intensive care support. All 21 patients had noticeable gastrointestinal symptoms during the early stage of illness and high levels of inflammatory markers. 19 (90%) had evidence of recent SARS-CoV-2 infection (positive RT-PCR result in 8/21, positive IgG antibody detection in 19/21). All 21 patients received intravenous immunoglobulin and 10 (48%) also received corticosteroids. The clinical outcome was favourable in all patients. Moderate coronary artery dilations were detected in 5 (24%) of the patients during hospital stay. By 15 May 2020, after 8 (5-17) days of hospital stay, all patients were discharged home.
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