Critical care course of pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 and response to immunomodulation.
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
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
Citations
Altmetric:
Affiliation
Other Contributors
Publication date
2020-12-04
Collections
Research Projects
Organizational Units
Journal Issue
Abstract
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.
Citation
Richens N, Kanthimathinathan HK, Sontakke S, Chikermane A, Jyothish D, Hackett S, Welch SB, Al-Abadi E, Duncan HP, Richter AG, Scholefield BR. Critical Care Course of Pediatric Inflammatory Multisystem Syndrome Temporally Associated with SARS-CoV-2 and Response to Immunomodulation. J Pediatr Intensive Care. 2020 Dec 4;11(2):124-129. doi: 10.1055/s-0040-1721456
Type
Article