Specialty follow -up care after hospital discharge of patients with multisystem inflammatory syndrome in children associated with COVID-19 from a rural tertiary-care hospital

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-05-01 DOI:10.1016/j.pedneo.2023.05.011
Inga Aikman , Brandon Wright , Stacey Applegate , Andrea Whitfield , Kamel Alachraf , Sruthipriya Sridhar , Dmitry Tumin , Salma Syed
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Abstract

Background

The clinical features of Multisystem Inflammatory Syndrome in Children (MIS-C) have been well documented, but there is limited data regarding the short term and longitudinal outcomes of children living in rural areas. We report the demographic and clinical features, as well as the multi-specialty follow-up of patients with MIS-C served by a large tertiary care rural health system.

Methods

Patients that met the Centers for Disease Control (CDC) case definition of MIS-C admitted between March 1, 2020, and March 31, 2021, were included in this case series. Manual chart review was used to report demographic characteristics, clinical, laboratory and radiologic features during acute hospitalization and multispecialty follow-up, and adherence to follow-up 6–10 weeks after hospital discharge.

Results

Twenty-one patients with MIS-C were admitted at our center during the review period. Ninety percent of the cohort required intensive care during hospitalization. Of 19 patients with measured ejection fractions, 52 % had some degree of left ventricular dysfunction on admission; nine patients had electrocardiogram changes on admission. The majority of patients had elevated inflammatory markers during hospitalization. Most patients had resolution of symptoms, improvement in inflammatory markers, and normal cardiac function at the time of discharge. Follow-up with pediatric cardiology, hematology-oncology and infectious disease was indicated for most patients at discharge. Of these, 100 % of patients kept initial follow-up appointments with pediatric cardiology and infectious disease, while 94 % kept initial follow-up appointments with pediatric hematology-oncology.

Conclusion

Though most patients were critically ill during hospitalization, the majority had resolution of cardiac abnormalities and inflammatory markers at discharge and timely follow-up with multiple subspecialists after admission with MIS-C.

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农村地区护理医院新冠肺炎相关儿童多系统炎症综合征患者出院后的专业随访护理。
背景:儿童多系统炎症综合征(MIS-C)的临床特征已被充分记录,但关于农村地区儿童的短期和纵向结果的数据有限。我们报告了人口统计学和临床特征,以及由大型三级医疗农村卫生系统服务的MIS-C患者的多专业随访。方法:符合美国疾病控制中心(CDC)在2020年3月1日至2021年3月31日期间入院的MIS-C病例定义的患者被纳入该病例系列。手动图表审查用于报告急性住院和多专科随访期间的人口统计学特征、临床、实验室和放射学特征,以及出院后6-10周的随访依从性。结果:在审查期间,我们中心收治了21名MIS-C患者。90%的患者在住院期间需要重症监护。在19名测得射血分数的患者中,52%的患者入院时有一定程度的左心室功能障碍;9名患者入院时出现心电图改变。大多数患者在住院期间炎症标志物升高。大多数患者出院时症状缓解,炎症标志物改善,心功能正常。大多数患者出院后需要进行儿科心脏病学、血液学、肿瘤学和传染病的随访。其中,100%的患者保留了儿科心脏病学和传染病的初始随访预约,94%的患者保留儿科血液肿瘤学的初始随访。结论:尽管大多数患者在住院期间病情危重,大多数患者出院时心脏异常和炎症标志物得到解决,并在因MIS-C入院后及时与多个亚专科医生进行随访。
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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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