1 - Serviço de Cardiologia Pediátrica, Hospital de Santa Marta, Centro Hospitalar Universitário de Lisboa Central, Lisboa
2 - Unidade de Cuidados Intensivos Pediátricos, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
3 - Unidade de Infeciologia Pediátrica, Hospital de Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
- The 8th Congresso f the European Academy of Paediatric Societies, 16-19 de Outubro de 2020, apresentação sob a forma de comunicação oral
Introduction: Since April 2020, paediatric intensive care societies resonated alerts regarding the emergence of a multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19.
Case report: The World Health Organization produced a preliminary case definition to help standardise and define MIS-C.1 Clinical criteria included fever for more than 3 days and two of the following: rash or bilateral non-purulent conjunctivitis or mucocutaneous inflammation signs, hypotension or shock, features of cardiac involvement, coagulopathy and acute gastrointestinal problems. Laboratory criteria included elevated inflammatory markers and the exclusion of other identifiable microbial causes. Inclusion criteria were the evidence of COVID-19 or contact with patients with COVID-19. Progression to warm, vasoplegic shock, refractory to volume resuscitation, and demanding haemodynamic support were seen in several cases. In addition to the supportive care, there were recommendations for anti-inflammatory strategies including intravenous immunoglobulin (IVIG), steroids and immunomodulators.
Conclusions: We report the first Portuguese case of an adolescent with MIS-C presenting with vasoplegic shock and cardiac injury, with the need for respiratory and cardiovascular support
Palavras Chave: Cytokines, COVID-19, MIS-C, myocarditis, vasoplegic shock.