Long-Term Cardiovascular Outcome in Children with MIS-C Linked to SARS-CoV-2 Infection—An Italian Multicenter Experience

Abstract

MIS-C is a multisystem inflammatory syndrome that is characterized by multi-organ failure and cardiac involvement. The aim of this study was to describe the long-term cardiovascular outcome in a cohort of MIS-C pediatric patients, who were admitted to two Italian Pediatric Referral Centers. Sixty-seven patients (mean age 8.7 ± 4.7 years, male 60%) were included; 65 (97%) of them showed cardiac involvement. All of the patients completed one month of the follow-up, and 47% completed 1 year of it. ECG abnormalities were present in 65% of them, arrhythmias were present in 9% of them during an acute phase and it disappeared at the point of discharge or later. Pericarditis were detected in 66% of them and disappeared after 6 months. Coronaritis was observed in 35% of the children during an acute phase, and there were no more instances at the 1-year point. An LV dysfunction was present in 65% of the patients at the beginning of the study, with them having a full recovery at the point of discharge and thereafter. Elevated values of the NTproBNP and hsTp were initially detected, which progressively decreased and normalized at the points of discharge and FU. The CMR at the point of FU, there was a presence of long-term myocardial scars in 50% of the patients that were tested. No deaths that were caused by MIS-C during the FU were recorded. Cardiac involvement in MIS-C patients is almost the rule, but the patients’ clinical course was satisfactory, and no additional events or sequelae were observed apart from there being long-term myocardial scars in 50% of the patients that underwent CMR.

Portable microfluidic plasmonic chip for fast real-time cardiac troponin I biomarker thermoplasmonic detection

“…Moreover, in patients with MIS-C, troponin values are usually elevated, suggesting that cardiac involvement in MIS-C patients is almost the rule. 46 However, in our study, in which all included pediatric patients were diagnosed with MIS-C, as well as in the literature, the high troponin values were not correlated with a poorer prognosis, as all patients' clinical course was satisfactory.…”

Cardiopulmonary Exercise Testing in Children and Young Adolescents after a Multisystem Inflammatory Syndrome: Physical Deconditioning or Residual Pathology?

“…To date, the primary outcomes identified are the worst left ventricular ejection fraction, the highest coronary artery z-score (of the left anterior descending or right coronary artery) [ 21 ], the presence of long-term myocardial scars at MRI [ 22 ], the occurrence of non-cardiac organ dysfunction, inflammation, and major medical events [ 21 ].…”

Differentiating abdominal pain due to COVID-19 associated multisystem inflammatory syndrome from children with acute appendicitis: a score system

“…The high morbidity and mortality of MIS-C is mostly secondary to cardiac involvement Therefore all patients with a suspicion of MIS-C are evaluated with echocardiography and cardiac markers. However, about 20% of MIS-C patients do not have cardiac damage and these are the group of patients we wanted to differentiate as they are harder to diagnose [29,30]. Therefore, we did not include markers as Troponin or NT-proBNP as they will prove cardiac involvement and MIS-C. Abdominal US has become an essential for distinguish acute appendicitis and other abdominal pathologies from MIS-C and is advocated by the consensus guideline [31].…”