Características clínicas e epidemiológicas da síndrome inflamatória multissistêmica em bebês e crianças associada à Covid-19 - revisão sistemática / Clinical and epidemiological characteristics of the multisystemic inflammatory syndrome in babies and children associated with Covid-19 - systematic review
DOI:
https://doi.org/10.34119/bjhrv4n5-420Keywords:
COVID-19, SARS-CoV-2 Infection, child.Abstract
HISTÓRICO: As autoridades de saúde mundiais, reconheceram em maio de 2020 a “Síndrome Inflamatória Multissistêmica Pediátrica” (MIS-C), graves manifestações em crianças relacionado ao COVID-19 que embora rara, está associado a internação em unidades de terapia intensiva pediátrica e óbito. Portanto, a análise dos estudos é necessária para melhorar a compreensão dos casos dessa nova síndrome assim como o manejo eficaz. MÉTODOS: Realizou-se buscas na Medline, Lilacas e Scopus, recuperando artigos de 1º de janeiro de 2020 a 5 de fevereiro de 2021. Selecionados de acordo com a estratégia PICO, respondendo a questão: Quais são as características clínicas, epidemiológicas e os possíveis tratamentos da MIS-C em lactentes, pré-escolares e crianças? Seguiu-se o modelo Prisma P Statement, aprovado pela plataforma PROSPERO, registro: 42021232938. RESULTADO: Foram selecionados 20 artigos de 171 para avaliação integral. Entre os principais sintomas, estão: febre (100%), alterações hematológicas (100%) e sintomas mucocutâneos (50% a 100%). Pelo menos 25% dos lactentes tiveram algum comprometimento cardíaco, em contrapartida 50% dos pré-escolares e crianças. 100% necessitou de internação hospitalar e 65% internou em unidade de terapia intensiva. As terapêuticas mais utilizadas foram a imunoglobulina intravenosa, corticosteroides e anticoagulantes/antiplaquetários. Relatos de alterações respiratórias graves com suporte de oxigênio e intubação são menos frequentes, assim como os óbitos. CONCLUSÃO: Apesar da baixa incidência do COVID-19 nos infantes, ela torna-se grave caso evolua para MIS-C. Nessa revisão resume-se tais características e relata-se o manejo da MIS-C. Embora a maioria das crianças necessite de cuidados intensivos, resultados favoráveis foram relatados, com baixas taxas de mortalidade.
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