Clinical characteristics and risk factors for hypotension in children with multisystem inflammatory syndrome related to SARS-CoV-2
10.3760/cma.j.issn.1673-4912.2024.03.007
- VernacularTitle:新型冠状病毒感染相关儿童多系统炎症综合征的临床特征及发生低血压的危险因素
- Author:
Guorui DAI
1
;
Jie WU
;
Jun LIU
;
Quan WANG
Author Information
1. 国家儿童医学中心 首都医科大学附属北京儿童医院急诊内科 100045
- Keywords:
Multisystem inflammatory syndrome;
Children;
Hypotension;
SARS-CoV-2 infection
- From:
Chinese Pediatric Emergency Medicine
2024;31(3):189-194
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To summarize the clinical characteristics of multisystem inflammatory syndrome in children（MIS-C）related to SARS-CoV-2 and analyze the risk factors for hypotension.Methods:The clinical data of children with MIS-C who visited Beijing Children's Hospital from January 2023 to March 2023 were retrospectively collected,and the clinical characteristics and risk factors for hypotension were analyzed.Results:Thirty-six patients were included,the median age was 3.1 (2.3,5.8) years; 61.1% were boys.All cases had a history of SARS-CoV-2 infection between 1 and 9 weeks before onset.Clinical symptoms included fever (100.0%); rash (94.4%); bilateral conjunctival congestion (88.8%); lips/oral cavity changes (100.0%); swollen hands and foot (61.1%); cervical lymphadenopathy (88.8%); acute gastrointestinal symptoms (61.1%) of diarrhea,abdominal pain and vomiting; neurologic manifestations (33.3%) of lethargy,headache,and convulsions; respiratory symptoms(41.6%) of cough,sore throat and shortness of breath.Nineteen (52.8%) cases developed hypotension and needed vasoactive drugs support to maintain blood pressure.Mechanical ventilation was required in four(11.1%) cases,and one patient was intubated and treated with continuous renal replacement therapy.The level of ferritin in hypotension group was significantly higher than those in normal blood pressure group( P＜0.05),while the levels of platelet count,serum sodium and potassium in hypotension group were significantly lower than those in normal blood pressure group( P＜0.05).Logistic regression multivariable analysis found the elevated serum ferritin ( OR=20.000,95% CI:2.750-145.481, P=0.003) was an independent risk factor for hypotension. Conclusions:MIS-C may be observed following SARS-CoV-2 infection.Various symptoms and signs,including fever,multiple organ dysfunction,and hypotension,may occur in children with MIS-C.Elevated ferritin is a risk factor for hypotension.
