Evaluation of Multisystem Inflammatory Syndrome in Children (MIS-C) Cases: Clinical Features and Cardiologic Findings

Abstract

Multisystem inflammatory syndrome in children (MIS-C) is a disease characterized by hyperinflammation with multiple organ involvement that develops after COVID-19 infection. In this study, we aimed to assess the clinical characteristics, cardiologic findings, and cardiac magnetic resonance imaging (MRI) results of MIS-C cases. Thirty-one patients diagnosed with MIS-C and followed up at Eskişehir Osmangazi University Faculty of Medicine between November 2020 and June 2022 were included in the study. The clinical and epidemiological characteristics and cardiological findings of the patients were evaluated retrospectively. Fifty-five percent of the thirty-one MIS-C cases were male and the mean age was 102 (2-204) months. The most common presenting symptoms were fever, rash, conjunctivitis, and abdominal pain. The most common cardiac findings were left ventricular dysfunction, myocarditis, and coronary artery dilatation. Cardiac MRI was performed in 4 of 8 patients with severe cardiac findings, and no pathologic findings were noted. Patients who had hypotension and cardiogenic shock at the time of admission, who had high ferritin, D-dimer, and IL -6 levels on laboratory tests, and who had left ventricular dysfunction and myocarditis on echocardiography had a high rate of ICU admission. The degree of cardiovascular involvement is important in following up on the disease and determining the treatment regimen. All patients should be monitored by echocardiography and cardiac MRI for possible permanent cardiac damage. Although MIS-C can lead to serious, life-threatening cardiac manifestations, early diagnosis and appropriate treatment can prevent the risk of serious cardiac morbidity and mortality in the future.