Mucocutaneous manifestations in children hospitalized with COVID-19.
COVID-19
SARS-CoV-2
multisystem inflammatory syndrome
pediatric dermatology
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
07 2021
07 2021
Historique:
received:
19
01
2021
revised:
16
03
2021
accepted:
24
03
2021
pubmed:
6
4
2021
medline:
25
6
2021
entrez:
5
4
2021
Statut:
ppublish
Résumé
Cutaneous manifestations in hospitalized children with SARS-CoV-2 have not been studied systematically. To describe the mucocutaneous involvement in pediatric patients with COVID-19 admitted to a pediatric institution in Madrid (Spain), located in a zone reporting among the highest prevalence of COVID-19 in Europe. A descriptive, analytical study was conducted on a series of 50 children hospitalized with COVID-19 between March 1, 2020, and November 30, 2020. Twenty-one patients presented with mucocutaneous symptoms: 18 patients with macular and/or papular exanthem, 17 with conjunctival hyperemia, and 9 with red cracked lips or strawberry tongue. Eighteen patients fulfilled criteria for multisystem inflammatory syndrome in children. Patients with mucocutaneous involvement tended to be older and presented to the emergency department with poor general status and extreme tachycardia, higher C-reactive protein and D-dimer levels, and lower lymphocyte counts than patients without skin signs. Mucocutaneous manifestations pose a higher risk of admission to the pediatric intensive care unit (odds ratio, 10.24; 95% confidence interval, 2.23-46.88; P = .003). Children hospitalized with COVID-19 frequently had mucocutaneous involvement, with most symptoms fulfilling criteria for multisystem inflammatory syndrome in children. Patients with an exanthem or conjunctival hyperemia at admission have a higher probability of pediatric intensive care admission than patients without mucocutaneous symptoms.
Sections du résumé
BACKGROUND
Cutaneous manifestations in hospitalized children with SARS-CoV-2 have not been studied systematically.
OBJECTIVE
To describe the mucocutaneous involvement in pediatric patients with COVID-19 admitted to a pediatric institution in Madrid (Spain), located in a zone reporting among the highest prevalence of COVID-19 in Europe.
METHODS
A descriptive, analytical study was conducted on a series of 50 children hospitalized with COVID-19 between March 1, 2020, and November 30, 2020.
RESULTS
Twenty-one patients presented with mucocutaneous symptoms: 18 patients with macular and/or papular exanthem, 17 with conjunctival hyperemia, and 9 with red cracked lips or strawberry tongue. Eighteen patients fulfilled criteria for multisystem inflammatory syndrome in children. Patients with mucocutaneous involvement tended to be older and presented to the emergency department with poor general status and extreme tachycardia, higher C-reactive protein and D-dimer levels, and lower lymphocyte counts than patients without skin signs. Mucocutaneous manifestations pose a higher risk of admission to the pediatric intensive care unit (odds ratio, 10.24; 95% confidence interval, 2.23-46.88; P = .003).
CONCLUSIONS
Children hospitalized with COVID-19 frequently had mucocutaneous involvement, with most symptoms fulfilling criteria for multisystem inflammatory syndrome in children. Patients with an exanthem or conjunctival hyperemia at admission have a higher probability of pediatric intensive care admission than patients without mucocutaneous symptoms.
Identifiants
pubmed: 33819537
pii: S0190-9622(21)00646-0
doi: 10.1016/j.jaad.2021.03.083
pmc: PMC8017917
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
88-94Informations de copyright
Copyright © 2021 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest None disclosed.
Références
JAMA Dermatol. 2021 Feb 1;157(2):207-212
pubmed: 33295957
An Pediatr (Engl Ed). 2021 Apr;94(4):270-272
pubmed: 33342687
N Engl J Med. 2020 Jul 9;383(2):187-190
pubmed: 32356945
BMJ. 2020 Aug 27;370:m3249
pubmed: 32960186
N Engl J Med. 2020 Apr 23;382(17):1663-1665
pubmed: 32187458
J Am Acad Dermatol. 2021 Feb;84(2):408-414
pubmed: 33323343
Arch Dis Child. 2020 Dec 1;:
pubmed: 33262177
J Am Acad Dermatol. 2020 Aug;83(2):486-492
pubmed: 32479979
Br J Dermatol. 2020 Oct;183(4):729-737
pubmed: 32562567
Pediatr Infect Dis J. 2020 Dec;39(12):e459-e462
pubmed: 33105340
Curr Opin Infect Dis. 2020 Dec;33(6):540-547
pubmed: 33027185
JAMA. 2020 Jul 21;324(3):259-269
pubmed: 32511692
N Engl J Med. 2020 Jul 23;383(4):334-346
pubmed: 32598831
Br J Dermatol. 2020 Jul;183(1):71-77
pubmed: 32348545
Clin Exp Dermatol. 2021 Apr;46(3):451-461
pubmed: 33166429
Lancet Child Adolesc Health. 2021 Feb;5(2):133-141
pubmed: 32956615
Euro Surveill. 2020 Jun;25(22):
pubmed: 32524957
Lancet. 2020 Aug 22;396(10250):535-544
pubmed: 32645347