Multisystemic inflammatory syndrome in children secondary to COVID-19

Year 2021, Volume: 4 Issue: 1, 29 - 34, 24.02.2021

Eviç Zeynep Akgün , Selim Öncel , Hafize Emine Sönmez

Abstract

Most of the coronavirus infections present with mild upper respiratory tract infection in humans. Atypical pneumonia cases with similar findings began to be reported in Wuhan, China, towards the end of 2019. In these cases, it was understood that the agent was a new type of coronavirus and was named SARS-CoV-2. Pediatric cases account for 2.1% to 8.4% of all SARS-CoV-2 cases. Unlike adults, acute respiratory distress syndrome is rare in children. The most common cause of SARS-CoV-2-associated hospitalization in children is the multisystemic inflammatory syndrome which is seen 2-4 weeks after the acute period. Kawasaki disease (KD)-like findings such as fever, rash and conjunctivitis are common in these patients while unlike KD, gastrointestinal system involvement, lymphopenia, thrombo-cytopenia and high B-type natriuretic peptide (BNP) levels are frequently observed. In this review, we aimed to increase awareness about the newly defined multisystemic inflammatory syndrome in childhood and to share the treatment algorithm which is developed in the light of our own experiences and literature.

Keywords

SARS-CoV-2, Multisystemic inflammatory syndrome in childhood, Kawasaki disease

Çocuklarda COVID-19’a ikincil gelişen multisistemik inflamatuar sendrom

Abstract

Koronavirüs enfeksiyonlarının çoğu, insanda hafif üst solunum yolu enfeksiyonu semptomları ile seyretmektedir. Çin’in Wuhan şehrinde 2019’un sonlarına doğru benzer özellikler gösteren atipik pnömoni vakaları bildirilmeye başlandı. Bu vakalarda etkenin yeni bir tip koronavirüs olduğu anlaşıldı ve SARS-CoV-2 olarak adlandırıldı. Tüm SARS-CoV-2 vakalarının %2,1 ila %8,4'ünü pediatrik vakalar oluşturmaktadır. Yetişkinlerden farklı olarak, ciddi solunum yetmezliği ve akut solunum sıkıntısı sendromu tablosu nadirdir. Çocuklarda en sık SARS-CoV-2 ilişkili hastane yatışı akut dönemden 2-4 hafta sonra görülen çocukluk çağının multisistemik inflamatuar sendromudur. Bu hasta grubunda ateş, döküntü konjonktuvit gibi Kavasaki hastalığı benzeri bulgular sıktır. Kavasaki hastalığından farklı olarak sıklıkla yaygın gastrointestinal sistem tutulumuna, lenfopeniye, trombositopeniye ve yüksek B-tipi natriüretik peptit (BNP) düzeylerine rastlanmaktadır. Bu derleme ile yeni tanımlanan çocukluk çağının multisistemik inflamatuar sendromu ile ilgili farkındalığı artırmak, kendi deneyimlerimiz ve literatür bilgileri ışığında geliştirdiğimiz tedavi yaklaşımımızı paylaşmayı amaçladık.

Keywords

SARS-CoV-2, Çocukluk çağının multisistemik inflamatuar sendromu, Kawasaki hastalığı

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