Complications and risk factors for severe outcome in children with measles

被引：13

作者：

Lo Vecchio, Andrea ^{[1
]}

Krzysztofiak, Andrzej ^{[2
]}

Montagnani, Carlotta ^{[3
]}

Valentini, Piero ^{[4
]}

Rossi, Nadia ^{[5
]}

Garazzino, Silvia ^{[6
]}

Raffaldi, Irene ^{[7
]}

Di Gangi, Maria ^{[8
]}

Esposito, Susanna ^{[9
]}

Vecchi, Barbara ^{[10
,11
]}

Melzi, Maria Luisa ^{[12
]}

Lanari, Marcello ^{[13
]}

Zavarise, Giorgio ^{[14
]}

Bosis, Samantha ^{[15
]}

Valenzise, Mariella ^{[16
]}

Cazzato, Salvatore ^{[17
]}

Sacco, Michele ^{[18
]}

Govoni, Maria Rita ^{[19
]}

Mozzo, Elena ^{[20
]}

Cambriglia, Maria Donata ^{[1
]}

Bruzzese, Eugenia ^{[1
]}

Di Camillo, Chiara ^{[2
,21
]}

Pata, Davide ^{[4
]}

Graziosi, Alessandro ^{[5
]}

Sala, Debora ^{[12
]}

Magurano, Fabio ^{[22
,23
]}

Villani, Alberto ^{[2
]}

Guarino, Alfredo ^{[1
]}

Galli, Luisa ^{[3
,22
,23
]}

机构：

[1] Univ Naples Federico II, Sect Pediat, Dept Translat Med Sci, Naples, Italy

[2] Childrens Hosp Bambino Gesu, Acad Dept Pediat, Pediat & Infect Dis Unit, Rome, Italy

[3] Anna Meyer Childrens Univ Hosp, Pediat Infect Dis Unit, Florence, Italy

[4] Univ Cattolica Sacro Cuore, A Gemelli Univ Hosp, Dept Women & Child Hlth, Pediat Branch, Rome, Italy

[5] Univ G dAnnunzio, Dept Pediat, Chieti, Italy

[6] Univ Turin, Regina Margherita Childrens Hosp, Dept Pediat, Infect Dis Unit, Turin, Italy

[7] Osped Civile Cirie, Dept Pediat & Neonatol, Turin, Italy

[8] Children Hosp ISMEP Cristina, Pediat Infect Dis Unit, Palermo, Italy

[9] Univ Perugia, Dept Surg & Biomed Sci, Pediat Clin, Perugia, Italy

[10] Azienda Osped Santa Maria, Pediat Unit, Terni, Italy

[11] Azienda Osped Santa Maria, Neonatal Intens Care Unit, Terni, Italy

[12] Milano Bicocca Univ, Pediat Dept, MBBM Fdn, Monza, Italy

[13] Alma Mater Studiorum Univ Bologna, Pediat Emergency Unit, Dept Med & Surg Sci, Bologna, Italy

[14] Hosp Negrar Sacro Cuore Don Calabria, Pediat Unit, Verona, Italy

[15] Univ Milan, Dept Pathophysiol & Transplantat, Pediat Highly Intens Care Unit, Fdn IRCCS Ca Granda Osped Maggiore Policlin, Milan, Italy

[16] Univ Messina, Dept Human Pathol Adulthood & Childhood, Pediat Unit, Messina, Italy

[17] Salesi Childrens Hosp, Dept Mother & Child Hlth, Pediat Unit, Ancona, Italy

[18] Res Inst Hosp Casa Sollievo Sofferenza San Giovan, Pediat Unit, Foggia, Italy

[19] Univ Hosp S Anna, Pediat Unit, Ferrara, Italy

[20] Hosp Dolo, Pediat Unit, Verona, Italy

[21] Univ Florence, Meyer Childrens Univ Hosp, Dept Hlth Sci, Florence, Italy

[22] MoRoNet, Natl Measles Reference Lab ISS, Rome, Italy

[23] MoRoNet, Network Subnatl Reference Lab Measles & Rubella, Rome, Italy

来源：

ARCHIVES OF DISEASE IN CHILDHOOD | 2020年 / 105卷 / 09期

关键词：

OUTBREAK;

D O I：

10.1136/archdischild-2018-315290

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Objective and design Risk factors for severe measles are poorly investigated in high-income countries. The Italian Society for Paediatric Infectious Diseases conducted a retrospective study in children hospitalised for measles from January 2016 to August 2017 to investigate the risk factors for severe outcome defined by the presence of long-lasting sequelae, need of intensive care or death. Results Nineteen hospitals enrolled 249 children (median age 14.5 months): 207 (83%) children developed a complication and 3 (1%) died. Neutropaenia was more commonly reported in children with B3-genotype compared with other genotypes (29.5% vs 7.7%, p=0.01). Pancreatitis (adjusted OR [aOR] 9.19, p=0.01) and encephalitis (aOR 7.02, p=0.04) were related to severe outcome in multivariable analysis, as well as C reactive protein (CRP) (aOR 1.1, p=0.028), the increase of which predicted severe outcome (area under the receiver operating characteristic curve 0.67, 95% CI 0.52 to 0.82). CRP values >2 mg/dL were related to higher risk of complications (OR 2.0, 95% CI 1.15 to 3.7, p=0.01) or severe outcome (OR 4.13, 95% CI 1.43 to 11.8, p<0.01). Conclusion The risk of severe outcome in measles is independent of age and underlying conditions, but is related to the development of organ complications and may be predicted by CRP value.

引用

页码：896 / 899

页数：4

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