Background: Coronavirus disease 2019(COVID-19) is responsible for significant lung disease in adults. Despite mild manifestations in most children, multisystem inflammatory syndrome (MIS-C) associated with COVID-19 is well-described in older children with cardiac manifestations. However, MIS-C-related cardiac manifestations are not as well-described in younger children. Methods: The study is a retrospective analysis of MIS-C patients under age 5 years admitted between May to November 2020 to a single-center. Included cases fulfilled the case definition of MIS-C according to RCPCH criteria with cardiac laboratory, ECG, or echocardiographic evidence of cardiac disease. Collected Data included patients’ demographics, laboratory results, echocardiographic findings, management, and outcomes. Results: Out of 16 MIS-C cases under 5 years, 10 (62.5%) had cardiac manifestations with a median age of 12 months, 9 (90%) were previously healthy. Cardiac manifestations included coronary arterial aneurysms or ectasia in 5 (50%) cases, 2 (20%) with isolated myopericarditis, coronary aneurysm with myocarditis in 2 (20%), and SVT in 1(10%). Intravenous immunoglobulins were given in all cases with coronary aneurysms or myocarditis. The median duration of hospitalization was 7(6-14) days; 2 (20%) cases with cardiac disease were mechanically ventilated and mortality in MIS-C cases below 5years was 12.5%. Normalization of systolic function occurred in half of the affected cases within one week and reached 100% by 30days of follow-up. Conclusion: MIS-C associated with SARS-CoV-2 has a high possibility of serious associated cardiac manifestations in children under the age of 5years with mortality and/or long-term morbidities such as coronary aneurysms even in previously healthy pediatric patients.

TDI detected subtle abnormalities in systolic and diastolic functions before and after HSCT, which suggests that a conditioning regimen may affect cardiac function.

Studies on Kawasaki disease (KD) in Arab countries are scarce, often providing incomplete data. This along with the benefits of multicenter research collaboratives led to the creation of the KD Arab Initiative [Kawarabi] consortium. An anonymous survey was completed among potential collaborative Arab medical institutions to assess burden of KD in those countries and resources available to physicians. An online 32-item survey was distributed to participating institutions after conducting face validity. One survey per institution was collected. Nineteen physicians from 12 countries completed the survey representing 19 out of 20 institutions (response rate of 95%). Fifteen (79%) institutions referred to the 2017 American Heart Association guidelines when managing a patient with KD. Intravenous immunoglobulin (IVIG) is not readily available at 2 institutions (11%) yet available in the country. In one center (5%), IVIG is imported on-demand. The knowledge and awareness among countries’ general population was graded (0 to 10) at median/interquartiles (IQR) 3 (2–5) and at median/IQR 7 (6–8) in the medical community outside their institution. Practice variations in KD management and treatment across Arab countries require solid proactive collaboration. The low awareness and knowledge estimates about KD among the general population contrasted with a high level among the medical community. The Kawarabi collaborative will offer a platform to assess disease burden of KD, among Arab population, decrease practice variation and foster population-based knowledge. Supplementary Information The online version contains supplementary material available at 10.1007/s00246-022-02844-w.

Plasma ET-1 concentrations are increased in children with cirrhosis, with or without ascites, compared with controls. Patients with cirrhosis and ascites have increased ET-1 concentrations compared with those without ascites. The degree of increase does not relate to the severity of portal hypertension. This increase tends to maintain systemic blood pressure but is associated with a decrease in renal function.