[墨西哥城一家三级儿科中心与 COVID-19 相关的小儿多系统炎症综合征的心血管表现]。

M. J. Granda-Jiménez, Itzel E Rios-Olivares, Carlos González-Rebeles-Guerrero, M. P. Márquez-Aguirre, J. A. Gutiérrez-Hernández, Laura Camacho-Reyes, Jesús De Rubens-Figueroa, Carlos A Corona-Villalobos
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引用次数: 0

摘要

目的揭示在SARS-CoV-2大流行期间被诊断为与COVID-19相关的小儿炎症性多系统综合征(PIMS)患者的心血管改变,以了解该疾病及其演变以及诊断后的最佳治疗方法。方法对 2020 年 3 月至 2021 年 12 月国家儿科研究所根据世界卫生组织标准确诊的 PIMS 患者进行回顾性、观察性、横断面分析研究。结果显示,休克状态与实验室指标的变化(血小板 144217.29 ± 139321.6 μL [p < 0.001]、降钙素原 27.37 ± 38.37 ng/ml [p = 0.05]和铁蛋白 1937.87 ± 2562.63 [p < 0.001])之间存在相关性。休克患者的心室功能明显低于未休克患者(49.6 ± 9.1% vs. 58.1 ± 8.4 %;t-学生 p <0.001),左冠状动脉损伤也明显低于未休克患者(p = 0.02)。NT-proBNP 与心室功能障碍之间存在相关性(Kruskal-Wallis p = 0.007)。结论 观察到的心血管改变按发生频率排列依次为心包积液(25.7%)、心肌炎(15%)、轻度心室功能障碍(13.5%)和以左冠状动脉和前降支动脉为主的小冠状动脉瘤。
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[Cardiovascular manifestations in pediatric multisystem inflammatory syndrome associated with COVID-19 in a tertiary care pediatric center in Mexico City].
Objective The objective is to expose the cardiovascular alterations in patients diagnosed with pediatric inflammatory multisystem syndrome (PIMS) associated with COVID-19 during the SARS-CoV-2 pandemic, in order to understand the disease, its evolution, and optimal management upon diagnosis. Method Retrospective, observational, cross-sectional analytical study of patients diagnosed with PIMS according to the criteria of the World Health Organization at the National Institute of Pediatrics, from March 2020 to December 2021. Results During the study period, 77 patients with PIMS were diagnosed. The results showed correlation between the shock state and alteration of laboratory markers (platelets 144217.29 ± 139321.6 μL [p < 0.001], procalcitonin 27.37 ± 38.37 ng/ml [p = 0.05] and ferritin 1937.87 ± 2562.63 [p < 0.001]). The ventricular function in patients with shock was significantly lower compared to those without shock (49.6 ± 9.1% vs. 58.1 ± 8.4 %; t-Student p < 0.001), as well as injury to the left coronary artery (p = 0.02). There is a correlation between NT-proBNP and ventricular dysfunction (Kruskal-Wallis p = 0.007). Statistical significance was found in the association between death, elevation of inflammatory markers and ventricular dysfunction (p < 0.001). Conclusions The cardiovascular alterations observed, in order of frequency, were pericardial effusion (25.7%), myocarditis (15%), mild ventricular dysfunction (13.5%) and small coronary aneurysm with predominance of the left coronary artery and the anterior descending one.
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