Clinical characteristics and predictors of adverse outcomes in children with acute rheumatic fever from a high-endemic region of Brazil - Report - MDSpire
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Clinical characteristics and predictors of adverse outcomes in children with acute rheumatic fever from a high-endemic region of Brazil
Clinical Features and Risk Factors for Negative Outcomes in Pediatric Acute Rheumatic Fever
Overview
Revise to correctly state that the absence of fever is associated with lower risk of severe outcomes.
Background
Acute rheumatic fever (ARF) is a significant cause of cardiovascular morbidity in children, particularly in low- and middle-income countries. Identifying children at high risk for adverse outcomes is crucial for timely management and prevention of rheumatic heart disease (RHD). This study addresses the need for effective risk stratification tools in resource-limited settings.
Data Highlights
Characteristic
Value
Median Age
9 years
Female Percentage
46%
Carditis Prevalence
76%
Moderate-to-Severe Carditis
49%
Primary Outcome (Cardiac Surgery or Death)
13%
C-statistic
0.82
Key Findings
76% of children presented with carditis, with 49% having moderate-to-severe involvement.
Absence of fever was associated with a lower risk of adverse outcomes (OR 0.14).
Higher ESR levels were linked to increased risk (OR 1.04 per mm/h).
Lower hematocrit levels were also predictive of adverse outcomes (OR 0.85).
The final predictive model demonstrated good discrimination with a C-statistic of 0.82.
Healthcare providers should consider simple inflammatory and hematologic markers, such as ESR and hematocrit, in assessing pediatric ARF patients. Early identification of high-risk children can facilitate timely interventions to prevent progression to severe rheumatic heart disease.
Conclusion
The study underscores the importance of using readily available clinical markers to predict adverse outcomes in pediatric ARF, which can enhance risk stratification and management in endemic regions.
by Renata Fonseca Mendoza, Letícia Leão de Oliveira, Bernardo Fonseca Mendoza, Jose Luiz Padilha da Silva, Paulo Henrique M. Melo, José Augusto Almeida Barbosa, Géssica Silva Santana, Airandes Pinto, Ndate Fall, Andrea Beaton, Maria Carmo Pereira Nunes
Investigative report cites internal communications, VAERS data, and CDC case reviews describing myocarditis and pericarditis reports in adolescents and young adults after mRNA COVID-19 vaccination.
