Outpatient monitoring of patients with multisystem inflammatory syndrome (MIS-C): A mini review

Abstract

IntroductionAs we learn more about the novel multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 infection, the protocols for long-term follow-up have evolved and only some of these protocols have been published. Here, we review the current literature on follow-up guidelines in MIS-C patients.MethodsWe conducted a PUBMED search of all articles published on “MIS-C” and the term “follow-up” between 2020 and 2022. Inclusion criteria were that (1) the study was an observational study or case series, and (2) the study population included pediatric population who met the diagnostic criteria for MIS-C.ResultsThere were 206 publications on MIS-C and follow-up in the last 2 years with 11 studies that fit the inclusion criteria. These papers were representing 11 different centers and encompassed a total of 343 participants. Seven of the 11 studies had participants follow-up with their cardiologist within 1 month of discharge. Between 12% and 62% of patients within each study had depressed left ventricular ejection fraction (LVEF) at admission. At the initial follow-up visit, five studies showed a normal LVEF in all patients while the other seven studies showed 2%–13% patients continuing to have depressed LVEF. In eight of the 11 studies, 9%–52% of patients had coronary artery dilation at admission. At their initial follow-up visit, 3%–28% of patients continued to have coronary artery dilation.ConclusionThere is some institutional variation in the outpatient follow-up protocols in patients diagnosed with MIS-C. A standardized follow-up guidelines might be helpful to monitor long-term prognosis of these patients.

Six-month multidisciplinary follow-up in multisystem inflammatory syndrome in children: An Italian single-center experience

“…MIS-C is a severe consequence of SARS-CoV2 infection in children that is associated with significant multiorgan compromission (49). Literature data on the long-term outcome of MIS-C is limited (18)(19)(20)(21)(22)(23)(24)(25).…”

“…MIS-C may be recognized as post-COVID syndrome (16,17); additionally, longterm complications related to pro-inflammatory status in children with MIS-C may not be excluded. To date, a limited number of reports have analyzed them (18)(19)(20)(21)(22)(23)(24)(25).…”