Critical Care Course of Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 and Response to Immunomodulation

Content Provider	Scilit
Author	Richens, Nicholas Kanthimathinathan, Hari Krishnan Sontakke, Sanket Chikermane, Ashish Jyothish, Deepthi Hackett, Scott Welch, Steven B. Al-Abadi, Eslam Duncan, Heather P. Richter, Alex G. Scholefield, Barnaby R.
Copyright Year	2020
Description	We describe the critical care course of children with a novel hyperinflammatory syndrome associated with coronavirus disease 2019 (COVID-19) pediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with focus on trajectory before and after immunomodulation. Overall, 10 patients who met the U.K. Royal College of Pediatrics and Child Health case definition during a 2-month study period were analyzed. All tested positive for SARS-CoV-2 IgG antibody. Although only 20% were ventilated, 100% required inotropic or vasopressor support. All children had significantly raised inflammatory markers with a median C-reactive protein of 248 (175–263) mg/L, ferritin of 1,561 (726–2,255) µg/L, and troponin-I of 723 (351–2,235) ng/L. Six patients had moderately impaired myocardial function and two had severe impairment. None needed extracorporeal membrane oxygenation. Despite severe illness only a brief period of critical care support of 3 to 5 days was required. Eight received at least one dose of intravenous immunoglobulin. Six received high-dose steroids. Clinical improvement including cardiovascular stability and reduction in inflammatory markers may have occurred with and without immunomodulation.$ ^{*}$ Authors contributed equally to this study. Received: 27 July 2020 Accepted: 31 October 2020 Publication Date: 04 December 2020 (online) © 2020. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany
Related Links	http://www.thieme-connect.de/products/ejournals/pdf/10.1055/s-0040-1721456.pdf
Ending Page	129
Page Count	6
Starting Page	124
ISSN	21464618
DOI	10.1055/s-0040-1721456
Journal	Journal of Pediatric Intensive Care
Issue Number	02
Volume Number	11
Language	English
Publisher	Georg Thieme Verlag KG
Publisher Date	2020-12-04
Access Restriction	Open
Subject Keyword	Journal: Journal of Pediatric Intensive Care Pediatrics and Child Health Coronavirus Disease 2019 Toxic Shock Syndrome
Content Type	Text
Resource Type	Article
Subject	Critical Care and Intensive Care Medicine Pediatrics, Perinatology and Child Health