Background

A multisystem inflammatory syndrome in children (MIS-C) is associated with coronavirus disease 2019. The New York State Department of Health (NYSDOH) established active, statewide surveillance to describe hospitalized patients with the syndrome.

Methods

Hospitals in New York State reported cases of Kawasaki’s disease, toxic shock syndrome, myocarditis, and potential MIS-C in hospitalized patients younger than 21 years of age and sent medical records to the NYSDOH. We carried out descriptive analyses that summarized the clinical presentation, complications, and outcomes of patients who met the NYSDOH case definition for MIS-C between March 1 and May 10, 2020.

Results

As of May 10, 2020, a total of 191 potential cases were reported to the NYSDOH. Of 95 patients with confirmed MIS-C (laboratory-confirmed acute or recent severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] infection) and 4 with suspected MIS-C (met clinical and epidemiologic criteria), 53 (54%) were male; 31 of 78 (40%) were black, and 31 of 85 (36%) were Hispanic. A total of 31 patients (31%) were 0 to 5 years of age, 42 (42%) were 6 to 12 years of age, and 26 (26%) were 13 to 20 years of age. All presented with subjective fever or chills; 97% had tachycardia, 80% had gastrointestinal symptoms, 60% had rash, 56% had conjunctival injection, and 27% had mucosal changes. Elevated levels of C-reactive protein, d-dimer, and troponin were found in 100%, 91%, and 71% of the patients, respectively; 62% received vasopressor support, 53% had evidence of myocarditis, 80% were admitted to an intensive care unit, and 2 died. The median length of hospital stay was 6 days.

Conclusions

The emergence of multisystem inflammatory syndrome in children in New York State coincided with widespread SARS-CoV-2 transmission; this hyperinflammatory syndrome with dermatologic, mucocutaneous, and gastrointestinal manifestations was associated with cardiac dysfunction.

中文翻译：

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纽约州儿童多系统炎症综合症。

背景

儿童多系统炎性综合征（MIS-C）与2019年冠状病毒疾病相关。纽约州卫生部（NYSDOH）建立了活跃的，全州范围的监视措施，以描述住院该综合征的患者。

方法

纽约州的医院报告了21岁以下住院患者的川崎病，中毒性休克综合症，心肌炎和潜在的MIS-C病例，并将病历发送给了NYSDOH。我们进行了描述性分析，总结了在2020年3月1日至5月10日期间符合MIS-C的NYSDOH病例定义的患者的临床表现，并发症和结局。

结果

截至2020年5月10日，NYSDOH总共报告了191起潜在病例。在95例确诊MIS-C（实验室确诊的急性或近期严重急性呼吸综合征冠状病毒2 [SARS-CoV-2]感染）和4例疑似MIS-C（符合临床和流行病学标准）的患者中，有53例（54％）是男性；78名中的31名（40％）是黑人，而85名中的31名（36％）是西班牙裔。共有31位患者（31％）为0至5岁，42位（42％）为6至12岁，26位（26％）为13至20岁。全部表现为主观发烧或发冷；心动过速的比例为97％，有胃肠道症状的比例为80％，皮疹的比例为60％，结膜注射的比例为56％，粘膜改变的比例为27％。C反应蛋白水平升高，d-二聚体和肌钙蛋白分别在100％，91％和71％的患者中发现；62％的患者接受了血管加压药支持，53％的患者有心肌炎的证据，80％的患者接受了重症监护病房，2例死亡。住院时间中位数为6天。

结论

纽约州儿童多系统炎症综合症的出现与SARS-CoV-2的广泛传播相吻合。这种具有皮肤病学，粘膜皮肤和胃肠道表现的高炎症综合症与心脏功能障碍有关。