Heart Involvement in Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children: The Retrospective Multicenter Cohort Data

Abstract

ObjectivesHeart involvement in multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) is a new challenging problem, requiring fast and reliable diagnostics and appropriate treatment. The aim of this study is to describe heart involvement in patients with MIS-C.Study DesignIn this retrospective, multicenter cohort study, data of 122 patients were included. All patients met WHO and CDC criteria of MIS-C.ResultsVarious types of heart involvement in MIS-C patients were observed. Patients with solely coronary artery lesions (CAL, n = 10, 8.2%) had typical features of Kawasaki disease: younger age, thrombocytosis and normal ferritin level, without giant CA aneurysms, thrombosis, myocardial infarction, shock, and ICU admission. Patients with solely myocardial involvement (MI, n = 30, 24.6%) had an older onset age, elevated ferritin, LDH, the highest D-dimer, H score, and thrombocytopenia level. The following clinical signs were associated with MI: gastrointestinal and central nervous system disorder, sore throat, swelling face, splenomegaly, shock, and treatment in the intensive care unit required. Patients with a combination of CAL and MI (n = 10, 8.2%) had symptoms similar to patients with solely MI, except for impressive thrombocytopenia. Shock and ICU admission were found in 34.7% of patients without heart involvement (n = 72, 59%). One major criterion [troponin > 32 pg/ml (52 points)] or at least two minor criteria [face swelling (32 points) and D-Dimer > 1,300 ng/ml (29 points)] were associated with MI (>32 points) with a sensitivity of 67.5% and a specificity of 88.9%.ConclusionThe above-suggested criteria can be added to routine diagnostic procedures to confirm MI in MIS-C patients.

Determination of Risk Factors for Severe Life-Threatening Course of Multisystem Inflammatory Syndrome Associated with COVID-19 in Children

“…Involvement of the cardiovascular system took place in 50% of patients in our study. Similar figures appear in the articles of other researchers, where it is described with a frequency from 33 to 67% [ 35 , 36 , 37 ]. The main cardiovascular manifestations in MIS-C were shock, cardiac arrhythmias, myocardial and pericardial damage, and dilatation of the coronary arteries [ 38 ].…”

Multisystem Inflammatory Syndrome in Children and Cardiac Involvement: A Quaternary Center Experience

“…1 Over 9,400 cases and 79 deaths due to MIS-C have been reported in the US. Studies published to date reported clinical and laboratory findings that could be associated with cardiac involvement and disease severity in patients with MIS-C. [6][7][8][9] Our prospective observational study has similar findings in terms of increased risk of cardiac involvement with increased inflammatory markers. However, there was no difference in cardiac and treatment outcomes related to erythrocyte sedimentation rate.…”

Epidemiologic and clinical characteristics of human bocavirus infection in children hospitalized for acute respiratory tract infection in Qingdao, China

“…According to the results of previous studies, AST, URE, and CK-MB were the biochemical indexes of liver dysfunction (Pilut et al, 2022 ), kidney injury (Zammel et al, 2022 ), and heart injury (Pilut et al, 2022 ), respectively. Elevated LDH levels were also often found in patients with myocarditis (Kostik et al, 2022 ). It cannot be ruled out that HBoV may affect these organs simultaneously, but it is equally possible that these observations are attributable to indirect immune responses of various organs to pathogens (Izumikawa, 2016 ).…”