美国州和地区流行病学家委员会/疾病预防控制中心监测SARS-CoV-2感染相关儿童多系统炎症综合征病例定义

IF 33.7 1区 医学 Q1 Medicine Mmwr Recommendations and Reports Pub Date : 2022-12-16 DOI:10.15585/mmwr.rr7104a1
Michael Melgar, Ellen H Lee, Allison D Miller, Sarah Lim, Catherine M Brown, Anna R Yousaf, Laura D Zambrano, Ermias D Belay, Shana Godfred-Cato, Joseph Y Abrams, Matthew E Oster, Angela P Campbell
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引用次数: 19

摘要

自2020年5月14日起,美国疾病预防控制中心对老年人群中与导致covid-19的病毒sars-cov-2感染相关的儿童多系统炎症综合征(misc)进行了全国监测。本报告总结了支持cste/cdc misc监测病例定义组成部分的证据和理由,并描述了制定该定义所使用的方法。这些方法包括召集misc临床专家(即顾问):关于misc的识别及其与其他儿科疾病的区别,回顾现有文献,将misc表型与儿童COVID-19和其他高炎症综合征进行比较,以及回顾性应用不同标准对先前报告给CDC的misc病例的数据。与2020年cdc misc病例定义相比,cste/cdc对misc的监测病例定义包括四个重要变化。这些变化是1)没有规定的主观或测量发烧的持续时间;2) c反应蛋白≥3.0 mg/dl提示全身性炎症;3)调整器官系统受累的标准,包括增加休克作为一个单独的类别,并消除呼吸、神经和肾脏标准;4)与misc疾病相关的sars-cov-2实验室阳性检测时间的新要求。虽然misc不是全国必须报告的疾病,报告是自愿的,但cste和CDC建议所有州和地区从2023年1月1日开始报告所有符合cste/ CDC misc监测病例定义的确诊、可能或疑似标准的病例,对于在该日期或之后发病的misc疾病病例:
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Council of State and Territorial Epidemiologists/CDC Surveillance Case Definition for Multisystem Inflammatory Syndrome in Children Associated with SARS-CoV-2 Infection - United States.

Since may 14, 2020, cdc has conducted national surveillance for multisystem inflammatory syndrome in children (mis-c) associated with infection with sars-cov-2, the virus that causes covid-19, among persons aged <21>adddd

This report summarizes the evidence and rationale supporting the components of the cste/cdc mis-c surveillance case definition and describes the methods used to develop the definition. these methods included convening mis-c clinical experts (i.e., consultants): regarding identification of MIS-C and its distinction from other pediatric conditions, a review of available literature comparing MIS-C phenotype with that of pediatric COVID-19 and other hyperinflammatory syndromes, and retrospective application of different criteria to data from MIS-C cases previously reported to CDC.

The cste/cdc surveillance case definition for mis-c includes four important changes, in comparison with the 2020 cdc mis-c case definition. these changes are 1) no required duration of subjective or measured fever; 2) requirement of c-reactive protein ≥3.0 mg/dl to indicate systemic inflammation; 3) adjustments to criteria of organ system involvement to include addition of shock as a separate category and elimination of respiratory, neurologic, and renal criteria; and 4) new requirements on timing of positive sars-cov-2 laboratory testing relative to the mis-c illness. although mis-c is not a nationally notifiable condition and reporting is voluntary, cste and cdc recommend that all states and territories report all cases meeting confirmed, probable, or suspect criteria of the cste/cdc mis-c surveillance case definition beginning january 1, 2023, for cases with mis-c illness onset on or after that date:

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来源期刊
Mmwr Recommendations and Reports
Mmwr Recommendations and Reports PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-
CiteScore
36.00
自引率
0.00%
发文量
3
期刊介绍: The MMWR series of publications is published by the Office of Science, Centers for Disease Control and Prevention (CDC), U.S. The MMWR Recommendations and Reports contain in-depth articles that relay policy statements for prevention and treatment in all areas in the CDC’s scope of responsibility (e.g., recommendations from the Advisory Committee on Immunization Practices).
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