Kawasaki-multisystem inflammatory syndrome in children in the delayed period of coronavirus infection (covid-19): modern state of the problem and possible new approaches to treatment (plasmapheresis)

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COVID-19 infection usually occurs in children in a mild form, but some of them in a delayed period (one or several weeks after acute infection with COVID-19) may develop a severe inflammatory disease with clinical manifestations similar to toxic shock syndrome (Kawasaki disease), classified as multisystem inflammatory syndrome in children (MISC). It is possible that the syndrome has only a temporary connection with the COVID-19 infection. In the future, new associations of such clinical manifestations with other infectious (or non-infectious) diseases may appear. But currently, all children in the described cohorts with MISC have an association with COVID-19 infection. It is believed that the syndrome is initiated by an excessive adaptive immune response with the formation of autoantibodies. Treatment is based on anti-inflammatory, including steroid therapy, the possible use of intravenous immunoglobulin, aspirin, interleukin 1 and 6 receptor antagonists. The article analyzes current views on Kawasaki-multisystem inflammatory syndrome in children in the delayed period of COVID-19 coronavirus infection in the aspects of diagnosis, pathogenesis, clinical manifestations (with a discussion of foreign and Russian studies) and approaches to therapy and possible prevention, including the possibility of using plasmapheresis in complex therapy.

作者简介

O. Groznova

Research Clinical Institute of Pediatrics named after acad. Yu.E. Veltischeva; Russian National Research Medical University. N.I. Pirogov; Charitable Foundation for Medical and Social Genetic Projects "Genome of Life"

编辑信件的主要联系方式.
Email: ogroznova@gmail.com

MD, Dr. Sci. (Med.), Chief Researcher of the Department of Pediatric Cardiology and Arrhythmology

俄罗斯联邦, Moscow

V. Warriors

First Saint Petersburg State Medical University named after I.I. acad. I.P. Pavlova

Email: voinof@mail.ru

MD, Dr. Sci. (Med.), Professor, Head of the Therapeutic Apheresis Department

俄罗斯联邦, Saint Petersburg

D. Donich

SWISS Group AG

Email: dr.dorina@a-swiss.org

MD, Dr. Sci. (Med.), Scientific Director

瑞士, Lucerne

V. Vetrov

Saint Petersburg State Pediatric Medical University

Email: vetrovplasma@mail.ru

MD, Dr. Sci. (Med.), Associate Professor, Department of Сhief Neonatology with Cours Obstetric and Gynecology, Chief Cabinet Efferent Therapy in Center Perinatolology

俄罗斯联邦, Saint Petersburg

D. Ivanov

Saint Petersburg State Pediatric Medical University

Email: doivanov@yandex.ru

MD, Dr. Sci. (Med.), Professor, Head of the Department of Neonatology with Courses in Neurology and Obstetrics-Gynecology, Faculty of Postgraduate and Additional Professional Education, Rector

俄罗斯联邦, Saint Petersburg

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2. Fig. 1. Pathogenesis of multisystem inflammatory syndrome in children [9]. ACE2 – receptors for angiotensin-converting enzyme 2; TNF-β – tumor necrosis factor β; IL – interleukins

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3. Fig. 2. Outpatient plasmapheresis procedure for children with multisystem inflammatory syndrome

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版权所有 © Groznova O., Warriors V., Donich D., Vetrov V., Ivanov D., 2021

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