The novel coronavirus disease (COVID-19) may induce multisystem inflammatory syndrome in children, which may be associated with Kawasaki-like disease, and cardiac injury. In this study, we presented three male adolescents with multisystem inflammatory syndrome and myocardial injury admitted to the hospital during the peak of COVID-19 pandemic. All of the three patients had a history of fever, gastrointestinal symptoms, polymorph rash, non-exudative conjunctivitis, and signs of acute myocarditis. One of them had renal failure. Previously, they did not have an acute infection. Upon admission, they were hypotensive and tachycardic. A nasopharyngeal swab for SARS-CoV-2 on reverse transcription-polymerase chain reaction (PCR) assay was negative, but neutralizing viral antibodies were positive. In combination with blood tests, ECG, echocardiography and computerized tomography (CT), a multisystem inflammatory syndrome associated with acute myocarditis with mild to moderate systolic dysfunction and dilated coronary arteries were diagnosed. Two of three patients had shock syndrome and required inotropic support. All patients were treated with intravenous immunoglobulins. The second patient had a fever up to 102.2°F (39°C) three days after intravenous immunoglobulins. Further, he was treated according to protocols for refractory Kawasaki disease, with an intravenous methylprednisolone pulse therapy and aspirin. After a few hours, he became afebrile and the clinical signs disappeared. The favorable short-term outcome may reflect the early recognition and adequate therapy; however, the long-term outcomes are currently unknown.

中文翻译：

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SARS-CoV-2大流行中的川崎样疾病和急性心肌炎-三个青少年的报告。

新型冠状病毒疾病（COVID-19）可能诱发儿童多系统炎症综合症，可能与川崎样疾病和心脏损伤有关。在这项研究中，我们介绍了在COVID-19大流行高峰期间入院的三名患有多系统炎性综合征和心肌损伤的男性青少年。三名患者均具有发烧，胃肠道症状，多形性皮疹，非渗出性结膜炎和急性心肌炎体征的病史。其中之一患有肾衰竭。以前，他们没有急性感染。入院时，他们血压低且心动过速。逆转录-聚合酶链反应（PCR）检测的SARS-CoV-2鼻咽拭子阴性，而中和病毒抗体阳性。结合验血，心电图，超声心动图和计算机断层扫描（CT）被诊断为多发性炎症综合征，伴有轻度至中度收缩功能障碍和冠状动脉扩张的急性心肌炎。三分之二的患者患有休克综合征，需要正性肌力支持。所有患者均接受静脉注射免疫球蛋白治疗。静脉注射免疫球蛋白三天后，第二名患者发烧至102.2°F（39°C）。此外，根据难治性川崎病的治疗方案，他接受了静脉注射甲基强的松龙脉搏疗法和阿司匹林治疗。几个小时后，他发热了，临床体征消失了。有利的短期结果可能反映了早期识别和适当的治疗；但是，目前尚不清楚长期结果。诊断为伴有轻度至中度收缩功能异常和冠状动脉扩张的急性心肌炎相关的多系统炎症综合症。三分之二的患者患有休克综合征，需要正性肌力支持。所有患者均接受静脉注射免疫球蛋白治疗。静脉注射免疫球蛋白三天后，第二名患者发烧至102.2°F（39°C）。此外，根据难治性川崎病的治疗方案，他接受了静脉注射甲基强的松龙脉搏疗法和阿司匹林治疗。几个小时后，他发热了，临床体征消失了。有利的短期结果可能反映了早期识别和适当的治疗；但是，目前尚不清楚长期结果。诊断为伴有轻度至中度收缩功能异常和冠状动脉扩张的急性心肌炎相关的多系统炎症综合症。三分之二的患者患有休克综合征，需要正性肌力支持。所有患者均接受静脉注射免疫球蛋白治疗。静脉注射免疫球蛋白三天后，第二名患者发烧至102.2°F（39°C）。此外，根据难治性川崎病的治疗方案，他接受了静脉注射甲基强的松龙脉搏疗法和阿司匹林治疗。几个小时后，他发热了，临床体征消失了。有利的短期结果可能反映了早期识别和适当的治疗；但是，目前尚不清楚长期结果。