A Review of Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19

2020 ◽  
Vol 24 (4) ◽  
Author(s):  
Alireza Ghodsi ◽  
Abdolreza Malek ◽  
Sara Ghahremani
Keyword(s):  
Clinical Presentation ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Organ Involvement ◽  
High Morbidity ◽  
Laboratory Findings ◽  
Persistent Fever ◽  
Number Of Children ◽  
Relevant Evidence ◽  
Inflammatory Syndrome

: The coronavirus disease 2019 (COVID-19) pandemic, with a high morbidity and mortality rate, has affected all age groups. COVID-19 infection in children usually has minimal symptoms, but the number of children with the inflammatory syndrome with clinical features similar to the Kawasaki disease has increased during the COVID-19 pandemic. Information about this emerging COVID-19 manifestation also called the multisystem inflammatory syndrome in children (MIS-C), is still incomplete. Patients typically present with persistent fever, followed by shock or multi-organ involvement. Laboratory findings and clinical presentation of this multi-organ involvement is part of the diagnostic criteria. Early treatment and multidisciplinary referral to pediatric specialists are essential. The prognosis of MIS-C is not yet fully understood. Although most children survive, several deaths have also been reported. Based on relevant evidence, this study aimed to review the pathophysiology, clinical manifestations, laboratory and imaging findings, diagnosis, treatment recommendations, and prognosis of MIS-C associated with COVID-19.

scholarly journals Clinical and Laboratoy Characteristics of Parvovirus B19 Infection During 2013/2014 Outbreak in Zagreb, Croatia

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S319-S320
Author(s):  
Mia Ajdukovic ◽  
Lucija Pejic ◽  
Neven Papic ◽  
Adriana Vince
Keyword(s):  
Clinical Presentation ◽  
Parvovirus B19 ◽  
Age Groups ◽  
Clinical Manifestations ◽  
University Hospital ◽  
Complication Rates ◽  
Laboratory Findings ◽  
Mild Anemia ◽  
Parvovirus B19 Infection ◽  
The University

Abstract Background Human Parvovirus B19 (HPV-B19) occurs worldwide and causes mild, acute exanthematous disease that occurs in a form of cyclic local epidemics. The aim of this study was to analyze clinical features and complication rates of acute HPV-B19 infection in different age groups. Methods We retrospectively reviewed the charts of 718 consecutive patients clinicaly diagnosed with acute HPV-B19 infection who visited outpatient department at the University Hospital for Infectious Diseases in Zagreb, Croatia during 2013–2014 outbreak. In 212 patients (of 298 tested) diagnosis was confirmed by positive IgM antibodies and/or HPV-B19 DNA in peripheral blood. Results Outbreak started in June 2013 and had a peak in April 2014, with highest prevalence in schoolchildren. There were no difference in clinical presentation or laboratory findings between clinicaly and serologicaly diagnosed patients. Biphasic presentation, fever, myalgia, arthralgia, headache and peripheral edema were more frequent in adults, but „slapped cheeks” was found predominantly in children. Complications were more common in adults, most commonly hematological disordes (mild anemia, thrombocytopenia and leukopenia), vasculitis, hepatitis and aseptic meningitis. There were no deaths in our cohort. Conclusion Parvovirus B19 infection has different clinical presentation, laboratory findings and complications in children and adults. Since the diversity of the clinical manifestations in adults may be misleading, the infection in adults should be suspected when disease is prevalent in children. Disclosures `All authors: No reported disclosures.

scholarly journals COVID-19 in Children

2021 ◽  
Vol 41 (1) ◽  
pp. 15-21
Author(s):  
Diana Didović ◽  
Srđan Roglić ◽  
Lorna Stemberger-Marić ◽  
Ivana Valenčak-Ignjatić ◽  
Andrea Nikčević
Keyword(s):  
Clinical Presentation ◽  
Viral Infections ◽  
Rare Complication ◽  
Older Children ◽  
Symptomatic Infection ◽  
Number Of Children ◽  
Multisystem Involvement ◽  
Laboratory Results ◽  
Inflammatory Syndrome

COVID-19 in children accounts for up to 8% of all the cases and is less severe than in adults. This could be an underestimation. A significant number of children are asymptomatic. Symptomatic infection is hard to distinguish from other respiratory tract viral infections based on symptoms and laboratory results. Anosmia is the only symptom in children that is highly suggestive of COVID-19. Infected children mostly have a positive household member. However, the role of children in SARS-CoV-2 transmission is still controversial. Data suggest that schoolchildren have a greater impact in SARS-CoV-2 transmission compared to younger children. Multisystem inflammatory syndrome in children is a new entity reported since April 2020 and is considered a rare complication of SARS-CoV-2 infection. It occurs in previously healthy older children and adolescents presenting with multisystem involvement and elevated inflammatory markers. Most children respond well to immune-modifying therapy. Treatment of COVID-19 in children is based solely on data received from adults and consists of supportive treatment and, in rare occasions, antiviral therapy (remdesivir), corticosteroids (dexamethasone) and monoclonal antibodies (tocilizumab). Further studies in children are needed in order to better understand this disease. This article discusses clinical presentation and therapeutic options for COVID-19 in children.

scholarly journals Clinical and laboratory findings in elderly with Community-Acquired Pneumonia in Babol, northern Iran – 2017-2019

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Saleh Habibi ◽  
Arefeh Babazadeh ◽  
Soheil Ebrahimpour ◽  
Parisa Sabbagh ◽  
Mehran Shokri
Keyword(s):  
Older Adults ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Gastrointestinal Symptoms ◽  
Vital Signs ◽  
The Elderly ◽  
Community Acquired Pneumonia ◽  
Northern Iran ◽  
Laboratory Findings ◽  
Cross Sectional

Abstract Morbidity and mortality are higher in older adults with community-acquired pneumonia (CAP) than in other age groups. Also, CAP in older adults has various clinical manifestations with other. A higher mortality rate in the elderly with CAP may contribute to a delay in management. Consequently, the purpose of this study was to investigate the clinical and laboratory manifestations of CAP in the elderly. This cross-sectional study was conducted on 221 elderly patients with CAP who were admitted to Ayatollah Rouhani Hospital, in Babol, northern of Iran, in 2017-2019. Patient outcomes included 170 cases that recovered from CAP, and 51 cases that died of complications. Patients were evaluated in terms of their clinical and laboratory manifestations. The most common symptoms of pneumonia were cough (79.6%), sputum (73.8%), weakness (72.9%), fever (56%), dyspnea (46.2%). The most frequent underlying disease was ischemic heart disease (43.9%). In our study, clinical and laboratory characteristics in older patients with CAP were evaluated and compared with other studies confirming past findings, but there were differences in some cases, such as vital signs, gastrointestinal symptoms, and disturbance of the level of consciousness. Therefore, it recommends carefully taking the patients’ initial histories and accurately recording their clinical and laboratory symptoms.

scholarly journals Background History, Clinical Presentation and Laboratory Profile in Cases of Suspected Neurometabolic Disorders

2016 ◽  
Vol 39 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Mustafa Mahbub ◽  
AZM Mosiul Azam ◽  
Suraj C Mazumder ◽  
Bithi Debnath ◽  
Naila Zaman Khan
Keyword(s):  
Clinical Presentation ◽  
Clinical Manifestations ◽  
Normal Activity ◽  
New Delhi ◽  
Laboratory Findings ◽  
Neurometabolic Disorders ◽  
Wide Range ◽  
History Of ◽  
Background History ◽  
Biotinidase Activity

Background : Neurometabolic disorders (NMD) in children may present at any age with a wide range of clinical manifestations. Unexplained or intractable seizure is one of the important associations. Consanguinity, regression of development and sibling death are the clues to suspect neurometabolic disorders when laboratory support is limited. Laboratory findings however, provide the confirmatory diagnosis which is unavailable in Bangladesh.Objectives : To determine the association of consanguinity, regression of development, seizures, EEG findings and other laboratory investigations in children suspected to have neurometabolic disorders and to aid clinicians working in resourcepoor countries.Methodology : A retrospective analysis was done from the records of the patients suspected to have neurometabolic disorders admitted in the department of Neurosciences, Dhaka Shishu Hospital, Dhaka during the period of July 2007 to February 2011. Tandem Mass Spectrometry (TMS), biotinidase activity and other enzyme assay were done through a private laboratory in New Delhi, India.Results : Total 128 children were studied and the parents of 39 (31%) had history of consanguineous marriage. Seizure was associated with 96 (75%) children and abnormal EEG findings were recorded in 83 (65%). Plasma ammonia was done in 98 cases and found to be increased in 53 (54%) cases. Plasma lactate was done in 94 cases and found high in 40 (43%). TMS were done in 111 (85%) children and abnormality were found in 70 (63%) cases. Serum biotinidase activity was advised for 41 children as per TMS result and measured in 25 children of which deficient activity was found in 17(68%); borderline in 4 (16%) and normal activity in 4 (16%) cases.Conclusion: Background history and clinical presentation followed by stepwise laboratory investigation is necessary to identify neurometabolic disorders. Early and appropriate intervention can reduce neurodisability in many situations.Bangladesh J Child Health 2015; VOL 39 (1) :24-29

scholarly journals Analysis of Clinical Symptoms and Laboratory Profiles in Children with Juvenile Idiopathic Arthritis in Malopolska Region (Poland) in the Years 2007-2010

2014 ◽  
Vol 2 (1) ◽  
pp. 56-61
Author(s):  
Zbigniew Żuber ◽  
Urszula Kania ◽  
Anna Król-Zdechlikiewicz ◽  
Anna Morawska ◽  
Bożena Pilch ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Clinical Presentation ◽  
Clinical Symptoms ◽  
Age Groups ◽  
Connective Tissue Diseases ◽  
Unknown Aetiology ◽  
Laboratory Findings ◽  
Enthesitis Related Arthritis ◽  
Common Category ◽  
Diagnostic Capacity

Background: Juvenile idiopathic arthritis (JIA) is a heterogenic group of chronic inflammatory connective tissue diseases of unknown aetiology in children up to 16 years of age.Aim: The aim of this study was to analyse the incidence, clinical presentation and laboratory findings in children with JIA in Malopolska region.Materials and methods: A retrospective analysis included all children with JIA (N=251) hospitalized in the two reference rheumatology centres covering Malopolska region (Poland), between July 2007 and December 2010.Results: The annual incidence of JIA in Malopolska region was estimated at 9.5 per 100 000 children. Oligoarthritis (54.9%) was the most common category in all age groups with a tendency to decrease with age; from 71.4 % in children aged 1-6 years; 55.7% in aged 7-12 years to 39.3 % in aged 13-16 years. The frequency of polyarthritis and enthesitis-related arthritis was greater in adolescents (29.2 % and 22.5 %, respectively). HLA-B27 antigen and uveitis were most frequently found in children with enthesitis-related arthritis (58% and 18.5 %, respectively).Conclusions: The study suggests the improvement of diagnostic capacity of JIA during the last decade in Poland. In accordance with the existing data diverse clinical presentation of JIA categories and laboratory characteristics were proven.

scholarly journals Epidemiological, clinical, and laboratory findings for patients of different age groups with confirmed coronavirus disease 2019 (COVID-19) in a hospital in Saudi Arabia

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250955
Author(s):  
Mutasim E. Ibrahim ◽  
Obaid S. AL-Aklobi ◽  
Mosleh M. Abomughaid ◽  
Mushabab A. Al-Ghamdi
Keyword(s):  
Saudi Arabia ◽  
Laboratory Data ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Hemoglobin Concentration ◽  
The Elderly ◽  
Laboratory Findings ◽  
Reactive Protein ◽  
Creatine Kinase Mb ◽  
D Dimer

Background Although the coronavirus disease 2019 (COVID-19) pandemic continues to rage worldwide, clinical and laboratory studies of this disease have been limited in many countries. We investigated the epidemiologic, clinical, and laboratory findings of COVID-19 infected patients to identify the effective indicators correlated with the disease. Methods A retrospective study was conducted at King Abdullah Hospital in Bisha Province, Saudi Arabia, from March 20 to June 30, 2020. Patients of different age groups were confirmed as having COVID-19 infection using a real-time polymerase chain reaction. The demographic, clinical, and laboratory data of the patients were statistically analyzed. Results Of the 132 patients, 85 were male and 47 were female, with a mean age of 50.9 years (SD±16.7). The patients were elderly (n = 29) and adults (n = 103). Of these, 54 (40.9%) had comorbidities, (25%) were admitted to the intensive care unit (ICU), and 12 (9.1%) died. On admission, the main clinical manifestations were fever (84.1%), cough (64.4%), shortness of breath (25%), chest pain (20.5%), and fatigue (18.2%). In all patients, increased neutrophils and decreased lymphocytes were observed. Patients’ lactate dehydrogenase (LDH) was elevated. C-reactive protein (CRP) was elevated in 48.5%, D-dimer in 43.2%, and the erythrocyte sedimentation rate (ESR) in 40.9% of patients. The elderly showed higher neutrophil (p = 0.011) and lower lymphocyte (p = 0.009) counts than adults. Glucose, creatine kinase-MB, LDH, bilirubin, D-dimer, and ESR were significantly higher in the elderly than in the adults. The COVID-19 death group had a higher leucocyte count (p = 0.036), and higher urea (p = 0.029) and potassium (p = 0.022) than the recovered group but had a lower hemoglobin concentration (p = 0.018). A significant association was determined between COVID-19 death and the presence of cardiovascular disease (χ2(1) = 16.297, p<0.001), hypertension (χ2(1) = 12.034, p = 0.001), renal failure (χ2(1) = 3.843, p = 0. 05), old age (t (130) = 4.9, p <0.001), and ICU admission (χ2(1) = 17.6 (1), p<0.001). Conclusions Investigating some of the laboratory and clinical parameters could help assess the disease progression, risk of mortality, and follow up patients who could progress to a fatal condition.

COVID-19 and Nervous System: underestimated clinical and prognostic aspects

2020 ◽  
Vol 2 (4) ◽  
pp. 01-06
Author(s):  
Irami Filho
Keyword(s):  
Scientific Community ◽  
Retrospective Studies ◽  
Clinical Manifestations ◽  
Case Series ◽  
Molecular Targets ◽  
High Morbidity ◽  
Laboratory Findings ◽  
Cochrane Database ◽  
Organ Systems ◽  
The World

The coronavirus pandemic transformed the world abruptly due to the speed of transmission and high morbidity and mortality. Many deaths have been quantified, and the scientific community intensifies the search for molecular targets, protein sequences and polymorphisms on SARS-CoV-2, to improve the clinical evolution and survival of patients. Initially, COVID-19 was described with respiratory changes, flu, and fever. With the spread of the disease, clinical manifestations were observed in other organ systems, still unknown. In this sense, the present study describes the main neurological changes and laboratory findings. The literature review was identified in the central databases: Scielo, Google Scholar, PubMed / MedLine, Embase, and Cochrane Database. Twenty-five articles related to the theme were chosen, including reviews, case series, cohort, and retrospective studies. Neurological manifestations were predominantly anosmia/hyposmia, dysgeusia, ataxia, and seizures. According to the latest published studies, attention must be paid to isolated initial neurological events.

scholarly journals The role of gender in the prevalence of human leptospirosis in Albania

2018 ◽  
Vol 12 (03) ◽  
pp. 150-155 ◽  
Author(s):  
Edmond Puca ◽  
Pellumb Pipero ◽  
Arjan Harxhi ◽  
Erjona Abazaj ◽  
Arjet Gega ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Presentation ◽  
Age Groups ◽  
Clinical Manifestations ◽  
Epidemiological Data ◽  
Elisa Test ◽  
Human Leptospirosis ◽  
Males And Females ◽  
The Difference

Introduction: Leptospirosis is a zoonotic spirochetal disease with global importance, which continues to have a major impact on public health in developing countries. The prevalence of the disease is much higher in males. The objectives of this study were: to give some data and to share our experience with human leptospirosis in Albania; to describe the prevalence regarding to the role of gender in the prevalence of human leptospirosis; to make a gender specific analysis of the clinical manifestations in patients diagnosed and treated for leptospirosis in our service and to make a review of literature related to this hypothesis. Methodology: We reviewed the epidemiologic data, risk factors and differences in clinical presentation between males and females’ patients with leptospirosis. These data are analysed from hospitalized patients. Diagnosis of leptospirosis was established based on clinical presentation, epidemiological data and subsequently confirmed serologically by Anti-Leptospira IgM antibodies through ELISA test. Results: Between 2005-2016, 233 cases of confirmed leptospirosis were analysed. Males were 208 (89.27%) and 25 of patients (10.72%) were females in ratio 9:1 p < 0.001. The highest prevalence was observed in the 45-64 age groups. Overall mortality was found to be 8.58%, 19 were males and one female p < 0.001. Conclusions: There is a much higher prevalence of leptospirosis in middle aged men. Mortality rate seems to be similar in males and females. While the difference in prevalence may be related to exposure to risk factors, further investigation is necessary to study gender-based genetic and immunological predisposition.

scholarly journals Co-existence of multisystem inflammatory syndrome in children associated with COVID-19 and scrub typhus infection: a case series

2021 ◽  
Author(s):  
Sarbani M. Roy ◽  
Sushama Sahoo
Keyword(s):  
Clinical Features ◽  
Scrub Typhus ◽  
Virus Disease ◽  
Clinical Manifestations ◽  
Case Series ◽  
World Health ◽  
Laboratory Findings ◽  
Term Outcome ◽  
Corona Virus ◽  
Inflammatory Syndrome

We are in the midst of pandemic of corona virus disease (COVID-19), caused by the novel coronavirus severe acute respiratory syndrome corona virus-2 (SARS-CoV-2). A clinical entity with hyperinflammatory syndrome, defined by World Health Organization (WHO) as multisystem inflammatory syndrome in children (MIS-C) and adolescents, temporarily related to COVID-19, is being reported in this pandemic from several countries. MIS-C has overlapping clinical features of Kawasaki disease (KD). KD has been described in association with various organisms including dengue, scrub typhus. MIS-C with concomitant infection has rarely been reported in literature till date. We report on ten sick pediatric patients presented with clinical features of MIS-C, in whom diagnosis of concomitant scrub typhus were also made. This retrospective study was conducted in the department of pediatric medicine of a medical college, in a district town of West Bengal, India. SARS-CoV-2 immunoglobulin G level was elevated in all of them and they were also positive with Scrub typhus serology. We reviewed and analysed their basic informations, clinical manifestations, epidemiological history, laboratory findings, treatment and short term outcome. Median age was 24 months (range 4 months-8 years), male: female was 1:1. All the patients survived. Concomitant tropical infection in a patient with MIS-C may play an important role in determining the prognosis of such patients. Early detection and intervention will result in better management and intact survival of them.

scholarly journals Pediatric multisystem inflammatory syndrome associated with a new coronavirus infection: unresolved issues

2021 ◽  
Vol 13 (1) ◽  
pp. 13-20
Author(s):  
Yu. V. Lobzin ◽  
A. A. Vilnits ◽  
M. M. Kostik ◽  
M. K. Bekhtereva ◽  
A. N. Uskov ◽  
...  
Keyword(s):  
Clinical Manifestations ◽  
Number Of Children ◽  
Treatment Regimens ◽  
Almost Everywhere ◽  
Laboratory Confirmation ◽  
High Incidence ◽  
Life Threatening ◽  
Symptom Complex ◽  
Coronavirus Infection ◽  
Inflammatory Syndrome

Since March 2020, the first reports have appeared about the increasing, almost everywhere, number of children who have undergone a new coronovirus infection caused by SARS-Cov-2 with a symptom complex resembling the manifestations of Kawasaki disease. A special feature of the clinical manifestations of this syndrome, which is called “Pediatric multisystem inflammatory syndrome associated with COVID-19”, is the high incidence of life-threatening conditions caused by the sharp development of arterial hypotension against the background of cardiogenic or vasogenic shock.In St. Petersburg, since the end of November 2020, there has been a sharp surge in admissions of children to the ICU of various hospitals with the clinic of Pediatric multisystem inflammatory syndrome, who have laboratory confirmation of the transferred COVID-19.The purpose of this article is to attract the attention of doctors of various profiles, to combine efforts to study this pathology, to determine the criteria for verifying the diagnosis, optimal treatment regimens and dispensary monitoring of patients who have been ill.

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