1. COVID-19 associated multisystemic inflammatory syndrome in 614 children with and without overlap with Kawasaki disease-Turk MIS-C study group
- Author
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Dilek Yilmaz Ciftdogan, Yildiz Ekemen Keles, Benhur Sirvan Cetin, Nazan Dalgic Karabulut, Melike Emiroglu, Zafer Bagci, Ayse Buyukcam, Emine Hafize Erdeniz, Gul Arga, Edanur Yesil, Ozlem Cakici, Adem Karbuz, Zumrut Sahbudak Bal, Soner Sertan Kara, Arife Ozer, Ozge Metin Akcan, Sefika Elmas Bozdemir, Ayse Berna Anil, Hatice Uygun, Omer Kilic, Selda Hancerli Torun, Zuhal Umit, Murat Sutcu, Berfin Ozgokce Ozmen, Hatice Karaoglu Asrak, Gulsum Alkan, Ahu Kara Aksay, Cuneyt Ugur, Ahmet Ziya Birbilen, Burcu Bursal Duramaz, Esra Akyuz Ozkan, Ozgur Burakay, Sema Yildirim Arslan, Eda Karadag Oncel, Serkan Fazli Celik, Ahmet Osman Kilic, Seval Ozen, Remzi Sarikaya, Demet Demirkol, Gazi Arslan, Ozden Turel, Ahmet Sert, Ergul Sari, Zerrin Orbak, Irfan Oguz Sahin, Celal Varan, Hacer Akturk, Sadiye Kubra Tuter Oz, Fatih Durak, Mehmet Burhan Oflaz, Manolya Kara, Derya Karpuz, Mey Talip Petmezci, Nevin Hatipoglu, Selim Oncel, Mehmet Turgut, Ferhan Elmali, Ayper Somer, Necdet Kuyucu, Ener Cagri Dinleyici, Zafer Kurugöl, Ergin Ciftci, Ates Kara, BURSAL DURAMAZ, BURCU, TÜREL, ÖZDEN, Aktürk, Hacer, Çiftdoğan, Dilek Yılmaz, Keleş, Yıldız Ekemen, Çetin, Benhur Şirvan, Karabulut, Nazan Dalgıç, Emiroğlu, Melike, Bağcı, Zafer, Büyükçam, Ayşe, Erdeniz, Emine Hafize, Arga, Gül, Yeşil, Edanur, Çakıcı, Özlem, Karbuz, Adem, Bal, Zümrüt Şahbudak, Kara, Soner Sertan, Özer, Arife, Akcan, Özge Metin, Bozdemir, Şefika Elmas, Anıl, Ayşe Berna, Uygun, Hatice, Kılıç, Ömer, Torun, Selda Hancerli, Ümit, Zuhal, Sütcü, Murat, Özmen, Berfin ÖzgÖkce, Asrak, Hatice Karaoğlu, Alkan, Gülsüm, Aksay, Ahu Kara, Uğur, Cüneyt, Birbilen, Ahmet Ziya, Duramaz, Burcu Bursal, Özkan, Esra Akyüz, Burakay, Özgür, Arslan, Sema Yıldırım, Öncel, Eda Karadağ, Celik, Serkan Fazlı, Kılıç, Ahmet Osman, Özen, Seval, Sarıkaya, Remzi, Demirkol, Demet, Arslan, Gazi, Türel, Özden, Sert, Ahmet, Sarı, Ergül, Orbak, Zerrin, Şahin, İrfan Oğuz, Varan, Celal, Öz, Sadiye Kübra Tuter, Durak, Fatih, Oflaz, Mehmet Burhan, Kara, Manolya, Karpuz, Derya, Petmezci, Mey Talip, Hatipoğlu, Nevin, Öncel, Selim, Turgut, Mehmet, Elmalı, Ferhan, Somer, Ayper, Kuyucu, Necdet, Dinleyici, Ener Cağrı, Kurugöl, Zafer, Çiftci, Ergin, Kara, Ateş, Koç University Hospital, İstinye Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, Murat Sütçü / 0000-0002-2078-9796, Manolya Kara / 0000-0001-6234-7024, Sütçü, Murat, Murat Sütçü / AAR-5212-2020, Manolya Kara / AGI-2212-2022, Murat Sütçü / 55499199300, and Manolya Kara / 57213122996
- Subjects
Lethargy ,Kawasaki disease ,SARS-CoV-2 ,COVID-19 ,MIS-C ,Mucocutaneous Lymph Node Syndrome ,Pediatrics ,Systemic Inflammatory Response Syndrome ,Children ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Humans ,Original Article ,Child ,Procalcitonin ,Retrospective Studies - Abstract
Multisystemic inflammatory syndrome (MIS-C) diagnosis remains difficult because the clinical features overlap with Kawasaki disease (KD). The study aims to highlight the clinical and laboratory features and outcomes of patients with MISC whose clinical manifestations overlap with or without KD. This study is a retrospective analysis of a case series designed for patients aged 1 month to 18 years in 28 hospitals between November 1, 2020, and June 9, 2021. Patient demographics, complaints, laboratory results, echocardiographic results, system involvement, and outcomes were recorded. A total of 614 patients were enrolled; the median age was 7.4 years (interquartile range (IQR) 3.9-12 years). A total of 277 (45.1%) patients with MIS-C had manifestations that overlapped with KD, including 92 (33.3%) patients with complete KD and 185 (66.7%) with incomplete KD. Lymphocyte and platelet counts were significantly lower in patients with MISC, overlapped with KD (lymphocyte count 1080 vs. 1280 cells x mu L, p = 0.028; platelet count 166 vs. 216 cells x 10(3)/mu L, p < 0.001). The median serum procalcitonin levels were statistically higher in patients overlapped with KD (3.18 vs. 1.68 mu g/L, p = 0.001). Coronary artery dilatation was statistically significant in patients with overlap with KD (13.4% vs. 6.8%, p = 0.007), while myocarditis was significantly more common in patients without overlap with KD features (2.6% vs 7.4%, p = 0.009). The association between clinical and laboratory findings and overlap with KD was investigated. Age > 12 years reduced the risk of overlap with KD by 66% (p < 0.001, 95% CI 0.217-0.550), lethargy increased the risk of overlap with KD by 2.6-fold (p = 0.011, 95% CI 1.244-5.439), and each unit more albumin (g/dl) reduced the risk of overlap with KD by 60% (p < 0.001, 95% CI 0.298-0.559). Conclusion: Almost half of the patients with MISC had clinical features that overlapped with KD; in particular, incomplete KD was present. The median age was lower in patients with KD-like features. Lymphocyte and platelet counts were lower, and ferritin and procalcitonin levels were significantly higher in patients with overlap with KD., NA
- Published
- 2022