К вопросу о клинико-лабораторных особенностях мультисистемного воспалительного синдрома у детей, ассоциированного с SARS-CoV-2

Abstract

Objective. To analyze clinical manifestations, laboratory parameters, and findings of instrumental examination in children with SARS-CoV-2-related multisystem inflammatory syndrome (MIS). Patients and methods. This study included 60 children aged 1 to 18 years (mean age 8 years) diagnosed with MIS and treated in Khimki Regional Hospital between 06.2020 and 10.2021. All patients underwent standard examination. Results. The majority of MIS patients (87%) were treated in the intensive care unit (ICU) due to severity of their condition; 71% of them were transferred to ICU directly from the admission department. None of children received antiviral therapy upon first encounter with the virus. The proportion of patients with type A blood (group II) was 1.5 times higher than that in the general population. Nine children (15%) were overweight and 5 children (8.3%) were obese. Almost two-thirds of participants (64%) had 3 and 4 systems of organs simultaneously involved in the pathological process. Most commonly, the disease affected the gastrointestinal tract (88%), skin and mucous membranes (77%), cardiovascular system (77%), and urinary tract (43%). Children with MIS were characterized by moderate neutrophilic leukocytosis with a left shift, lymphopenia, thrombocytopenia, anemia, elevated CRP (up to 66x of the upper limit), elevated ferritin (up to 23x of the upper limit), elevated D-dimer, and prolonged aPTT. Conclusion. SARS-CoV-2-related MIS is one of the most severe manifestations of COVID-19 in children, and requires a differential diagnosis with bacterial infections. Key words: children, SARS-CoV-2 infection, multisystem inflammatory syndrome, risk factors