Table 1 Patients characteristics
Patient 1 | Patient 2 | Patient 3 | Patient 4 | Patient 5 | Patient 6 | Patient 7 | Patient 8 | ||
|---|---|---|---|---|---|---|---|---|---|
Demographics | |||||||||
Age (years) | 14 | 13 | 1 | 4 | 1 | 9 | 10 | 5 | |
Weight (kg) | 62 | 86 | 8.2 | 17 | 7.9 | 38.9 | 38 | 24.5 | |
Sex | Male | Female | Male | Male | Male | Female | Male | Male | |
Comorbidity | No | Obesity | Fallot tetralogy | No | No | No | No | No | |
Clinical condition | |||||||||
Cardiogenic shock | Yes | Yes | No | No | Yes | Yes | No | No | |
Ventricular arrythmia | Yes | No | No | No | Yes | No | No | No | |
MAS | No | Yes | Yes | Yes | No | No | No | No | |
Cardiac evaluation at admission | |||||||||
LVEF (%) | 37 | 30 | – | 45 | 37 | 29 | 32 | 40 | |
Subaortic VTI (cm) | 13 | 18 | – | 14 | 8 | 12 | 13 | 14 | |
LV dilatation | No | No | No | No | No | No | No | No | |
MI (grade) | Grade I | Grade I | – | Grade I | Grade III | Grade II | Grade II | Grade I | |
RV dysfunction | Yes | No | No | No | No | No | No | No | |
ECG | Fleeting ventricular arrhythmia | Normal | Normal | Normal | Vf bursts, st segment elevation | Normal | Normal | Normal | |
Laboratory findings at admission | |||||||||
CRP (mg/l) | 310 | 333 | 150 | 94 | 10 | 288 | 248 | 196 | |
PCT (μg/l) | 84.87 | 15.8 | 28.7 | 2.63 | 0.26 | 6.19 | 161.29 | 3.81 | |
Wbcs (/mm3) | 19,900 | 4870 | 16,690 | 11,230 | 10,260 | 17,090 | 5980 | 20,000 | |
Lymphocytes (/mm3) | 1350 | 370 | 1670 | 1680 | 2870 | 1590 | 950 | 1280 | |
Neutrophils (/mm3) | 17,270 | 4270 | 12,520 | 7640 | 6870 | 14,520 | 4800 | 18,260 | |
Serum creatinine (μmol/l) | 133 | 79 | 31 | 32 | 37 | 59 | 39 | 30 | |
NT pro BNP (ng/l) | 16,931 | 20,865 | 4269 | 2231 | 61,079 | 2591 | 7444 | 4105 | |
PCR SARS-CoV-2 (blood) | Negative | Negative | Positive | Positive | Negative | Negative | Negative | Positive | |
IgG SARS-CoV-2 | Positive | Positive | Negative | Positive | Negative | Positive | Positive | Negative | |
Other virus (blood) | No | No | No | No | PB19 (IgG + , IgM -, PCR -) | No | No | No | |
Treatment | |||||||||
Immunotherapy | Anakinra + IVIg | Anakinra + IVIg + CS | Anakinra + IVIg+ CS | Anakinra + IVIg + CS | Anakinra + IVIg | Anakinra + CS | Anakinra + CS | Anakinra + CS | |
Reason for initiating anakinra | Poor hemodynamic tolerance of IVIg | Poor hemodynamic tolerance of IVIg | MAS (bone marrow analysis, high blood ferritin and triglycerides) | Poor hemodynamic tolerance of IVIg | Severity of clinical picture | Severity of clinical picture | Major inflammatory state | Major inflammatory state | |
Time to start anakinra after admission (days) | 0 | 1 | 8 | 0 | 3 | 1 | 0 | 2 | |
Total anakinra treatment time (days) | 14 | 15 | 11 | 7 | 4 | 1 | 3 | 3 | |
Anakinra dosage per day | 200 mg | 200 mg | 6 mg/kg | 4 mg/kg | 4 mg/kg | 2 mg/kg | 4 mg/kg | 4 mg/kg | |
Max VIS score | 55 | 5 | 160 | 0 | 1275 | 20 | 0 | 0 | |
Total inotropic/ vasopressor support duration (days) | 1 | 1 | 4 | 0 | 4 | 2 | 0 | 0 | |
Diuretic | Yes | Yes | No | No | Yes | Yes | No | No | |
Other cardiovascular therapy | No | No | Milrinone | No | Milrinone; amiodarone; levosimendan | No | No | No | |
Length of stay in ICU (days) | 6 | 7 | 19 | 3 | 23 | 6 | 1 | 3 | |
Length (days) of non-invasive ventilation | 0 | 4 | 0 | 0 | 1 | 0 | 0 | 0 | |
Length (days) of invasive ventilation | 0 | 0 | 6 | 0 | 18 | 0 | 0 | 0 | |