This information was accurate at the time of publication. 由于COVID-19大流行的性质不断变化, some information may have changed since the original publication date.
儿童多系统炎症综合征(MIS-C) is a new type of health condition associated with COVID-19 that's being diagnosed among a small number of children across the world. MIS-C is a condition that causes different parts of the body to become inflamed, 包括心脏, 肺, 肾脏, 大脑, 皮肤。, 眼睛, 或者胃肠道器官. 目前尚不清楚是什么导致了misc, but children that have been diagnosed either had the virus that causes COVID-19 or had been around someone with COVID-19.
As health experts continue to learn about this new development, a panel of University of Utah Health and Primary Children's Hospital experts answered questions about what is known about MIS-C so far.
misc是如何被发现的?
医学博士安迪·帕维亚： Reports about MIS-C first came from the United Kingdom and London in April of 2020 of what appeared to be children who had 川崎病 感染COVID-19后. At the same time, similar cases were being reported in New York City and Italy. 在英国和美国.S., the cases appeared to peak about a month after the peak of infection of COVID-19.
什么是misc症状?
- 发热
- 腹部疼痛
- 呕吐
- 腹泻
- 颈部疼痛
- 皮疹
- 充血的眼睛
- 感觉特别累
帕维亚: The illness is characterized with children who come in with prolonged fever. 他们经常有严重的腹痛和皮疹, 然后发展成许多器官的炎症, 因此被称为多系统炎症综合征. 最常见的症状是皮疹和发烧. Less common symptoms include red 眼睛, swelling of the hands and feet, or swollen lymph nodes.
misc的心血管因素是什么?
张东南博士： 这似乎是最显著的特征之一. One of the most common heart findings we are seeing is that the muscle of the heart or squeeze of the heart is being affected. 在欧洲和英国的一些报道中, somewhere up to 50% of patients had decreased squeeze of the heart.
misc与风湿病有什么关系?
Erin treemarki， MD: We take care of children with high levels of 炎症 - specifically we see something that's called macrophage activation syndrome (马斯). 马斯 happens in a group of children who have a certain type of arthritis, 虽然大发娱乐在其他情况下也看到了. What happens is the immune system reacts to a trigger and either overreacts becoming very active or is unable to turn itself off and keeps producing levels of 炎症 or in some degrees, 这两个. We are seeing similar features in 马斯 and other types of significant 炎症 in MIS-C patients.
misc如何诊断?
A patient may undergo certain tests to look for 炎症 or other symptoms. 这些测试可能包括：
- 鼻拭子
- 血液测试
- 胸部x光片
- 心脏超声检查
- 腹部超音波
帕维亚: A PCR test looks for the virus that indicates an active infection. In these children, it's present about a third of the time. The other two-thirds generally have antibodies but no virus, although some have 这两个. The presence of antibodies indicates an infection in the past.
misc是如何治疗的?
帕维亚: Most children who become ill with MIS-C need treatment in the hospital. Some will need to be treated in the pediatric intensive care unit (ICU). The type of treatment currently being used for MIS-C patients is the treatment we use for 川崎病 due to 炎症 of the heart. 治疗是有效的. There have been a few deaths around the world so far and the majority of children have recovered well.
Truong: In terms of trial for MIS-C, we are still in the infancy of what we know. We don't know what works best at this point, but so far there has been promising evidence that 丙种球蛋白 有没有大发娱乐孩子退烧和消炎.
MIS-C情况下
帕维亚: 犹他州有一名患者被诊断为misc. Earlier patients who presented with 川崎病 will undergo testing to see if they actually had MIS-C. 在世界范围内，大约有200例misc病例.
病例范围从一岁以下到20岁. 平均年龄为7到8岁. This is different from 川崎病 which usually affects preschool children, 2至3岁.
在犹他州的病例中，有多少是严重的?
Jill Sweney博士： 犹他州为数不多的病人, one required admission to the intensive care unit (ICU) and needed medication to support blood pressure. 这些患者通常在3-5天内康复, but some reported cases that we have been hearing about presented much sicker and required mechanical ventilation and ECMO support.
帕维亚: Many of the patients that have been described so far have developed severe disease and have often ended up in the intensive care unit because of the heart muscle and the shock of low blood pressure.
死亡率是多少?
帕维亚: The threat is going to depend on how many children become infected with 冠状病毒. There's a lot we can do about that and can do to protect children such as social distancing, 保持良好的手部卫生, 戴着面具. If we don't control the spread of infection, then eventually we will see more cases.
为什么misc会影响儿童而不是成人?
帕维亚: 大发娱乐还不知道. There are a lot of things in the immune system in children that are quite different. The initial COVID-19 infection in children tends to be much milder - only 1-2% of cases in the US and around the world have been in children - and a very small percentage of children with the infection get sick enough to be hospitalized or receive intensive care. 这与年轻人非常不同.
关于MIS-C，家长应该知道些什么?
帕维亚: MIS-C appears to be rare, but parents should be attuned to sickness in their children. 如果孩子持续发烧, 剧烈腹痛, 皮疹, 和/或眼睛发红-联系你的医疗保健大发娱乐提供者.
关于misc大发娱乐所不知道的
帕维亚: MIS-C seems to follow at a substantial time after COVID-19 infection, 但大发娱乐不知道这种疾病的范围. We also don't know what the long-term consequences, if any, are going to be.
U of U Health的医生在做什么?
帕维亚: We are trying to see if we can understand the immune system, how the virus triggers MIS-C weeks after the illness, 最好的治疗方法是什么, 如果大发娱乐能及早干预.
医学博士安德鲁·帕维亚 Chief of the Division of Pediatric Infectious Diseases
University of Utah Health and Primary Children's Hospital
张东安博士； 儿科心脏病专家
University of Utah Health and Primary Children's Hospital
吉尔·斯威尼，医学博士； 儿科重症监护医师
University of Utah Health and Primary Children's Hospital
Erin treemarki， DO， 儿科风湿病学家
University of Utah Health and Primary Children's Hospital