학술논문
Hypertension after multisystem inflammatory syndrome in children (MIS-C).
Document Type
Article
Author
Source
Subject
*HYPERTENSION risk factors
*HYPERTENSION epidemiology
*ECHOCARDIOGRAPHY
*KRUSKAL-Wallis Test
*C-reactive protein
*MULTISYSTEM inflammatory syndrome
*CONFIDENCE intervals
*MULTIPLE regression analysis
*LEFT ventricular hypertrophy
*RETROSPECTIVE studies
*ACQUISITION of data
*RISK assessment
*MEDICAL records
*RESEARCH funding
*CHI-squared test
*DESCRIPTIVE statistics
*LOGISTIC regression analysis
*ODDS ratio
*PREHYPERTENSION
*CREATININE
*HOSPITAL care of children
*DISEASE risk factors
*DISEASE complications
*CHILDREN
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Language
ISSN
0931-041X
Abstract
Background: Multisystem inflammatory syndrome in children (MIS-C) is associated with SARS-CoV-2. Long-term consequences of MIS-C remain unknown. The objective was to describe the prevalence and clinical predictors of hypertension (HTN) and elevated blood pressure (BP) following MIS-C. Methods: A retrospective study of children ≤ 18 years admitted to a tertiary center with MIS-C was performed. HTN and elevated BP were classified as per the 2017 American Academy of Pediatrics Clinical Practice Guidelines and indexed to the 95th percentile. Data included demographics, inpatient clinical measures, and echocardiograms over 1-year follow-up. Data were analyzed using Kruskal–Wallis, chi-square, and logistic regression. Results: Among 63 children hospitalized with MIS-C (mean age 9.7 ± 4.2 years, 58.7% male, body mass index (BMI) z-score 0.59 ± 1.9), 14% had HTN, and 4% had elevated BP > 30 days post-hospitalization. Multivariate linear regression analysis showed that BMI z-score was significantly associated with higher mean systolic (β = 2.664, CI = 1.307–3.980, p < 0.001) and diastolic (β = 2.547, CI = 0.605–4.489, p = 0.012) BP index > 30 days post-hospitalization. Acute kidney injury (AKI) (23.8%) (OR = 2.977, CI = 1.778–4.987, p < 0.001), peak inpatient serum creatinine (OR = 2.524, CI = 1.344–4.740, p = 0.004), and maximum CRP (OR = 1.009, CI = 1.002–1.016, p = 0.014) were all associated with increased odds of post-hospitalization HTN. Left ventricular hypertrophy was present in 46% while hospitalized, compared to 10% at last follow-up. All had return of normal systolic function. Conclusions: Post-hospitalization HTN and elevated BP may be associated with MIS-C. Children with greater BMI or AKI may be at greater risk for developing HTN after MIS-C. MIS-C follow-up requires careful BP monitoring and antihypertensive medication consideration. [ABSTRACT FROM AUTHOR]