Cardiac echocardiogram findings of severe acute respiratory syndrome coronavirus-2-associated multi-system inflammatory syndrome in children

Abstract

Background: A novel paediatric disease, multi-system inflammatory syndrome in children, has emerged during the 2019 coronavirus disease pandemic. Objectives: To describe the short-term evolution of cardiac complications and associated risk factors in patients with multi-system inflammatory syndrome in children. Methods: Retrospective single-centre study of confirmed multi-system inflammatory syndrome in children treated from 29 March, 2020 to 1 September, 2020. Cardiac complications during the acute phase were defined as decreased systolic function, coronary artery abnormalities, pericardial effusion, or mitral and/or tricuspid valve regurgitation. Patients with or without cardiac complications were compared with chi-square, Fisher’s exact, and Wilcoxon rank sum. Results: Thirty-nine children with median (interquartile range) age 7.8 (3.6–12.7) years were included. Nineteen (49%) patients developed cardiac complications including systolic dysfunction (33%), valvular regurgitation (31%), coronary artery abnormalities (18%), and pericardial effusion (5%). At the time of the most recent follow-up, at a median (interquartile range) of 49 (26–61) days, cardiac complications resolved in 16/19 (84%) patients. Two patients had persistent mild systolic dysfunction and one patient had persistent coronary artery abnormality. Children with cardiac complications were more likely to have higher N-terminal B-type natriuretic peptide (p = 0.01), higher white blood cell count (p = 0.01), higher neutrophil count (p = 0.02), severe lymphopenia (p = 0.05), use of milrinone (p = 0.03), and intensive care requirement (p = 0.04). Conclusion: Patients with multi-system inflammatory syndrome in children had a high rate of cardiac complications in the acute phase, with associated inflammatory markers. Although cardiac complications resolved in 84% of patients, further long-term studies are needed to assess if the cardiac abnormalities (transient or persistent) are associated with major cardiac events.

Cardiac Assessment in Children with MIS-C: Late Magnetic Resonance Imaging Features

“…Several studies have reported the short-term outcomes of cardiac complications in children with MIS-C. Cardiac complications persisted during firsty and second months at follow-up in two studies [48,49]. Caro-Paton et al [50] showed [52].…”

Comparison of First and Second Wave Cohorts of Multisystem Inflammatory Disease Syndrome IN Children

“…Limitations of our study include the fact that we limited cardiac complications for comparison to coronary artery abnormalities or decreased systolic function, and did not include valvular regurgitation or pericardial effusion, although in our overall institutional cohort, these findings have been observed to be the most transient and likely to resolve during short-term follow-up. 3…”

“…Due to unusual severity, case 12 has been reported previously. 3 To calculate the incidence of myopericarditis associated with mRNA COVID-19 vaccination among Danish adolescents, the number of individuals 12-17 years of age who had received 1 dose of mRNA COVID-19 vaccine from May 15 to August 15, 2021, was attained from the National COVID-19-vaccine Database at the Statens Serum Institut.…”

Kawasaki Disease Arab Initiative [Kawarabi]: Establishment and Results of a Multicenter Survey

“…The recent emergence of 2019 coronavirus disease (COVID-19) and the similarity between KD and the Multi-System Inflammatory Syndrome in Children (MIS-C) brought to the stage the importance of studying KD globally [ 12 – 20 ]. Through professional and personal communications among peers in Middle Eastern countries, a growing concern and awareness toward KD was a recurrent theme.…”