Long-term Cardiovascular Outcomes of Multisystem Inflammatory Syndrome in Children Associated with COVID-19 using an Institution Based Algorithm

Abstract

Background: Cardiovascular involvement is a major cause of inpatient and intensive care unit morbidity related to Multisystem inflammatory syndrome in children (MIS-C). The objective of this study was to identify long-term cardiovascular manifestations of MIS-C. Methods: We included 80 consecutive patients admitted to the intensive care unit with MIS-C who were evaluated for a year in our follow-up clinic using an institution protocol. The outcome measures were cardiac biomarkers (troponin and BNP), electrocardiogram changes, echocardiographic findings cardiovascular magnetic resonance (CMR) and graded-exercise stress test (GXT) findings. Results: The cohort included patients aged between 6 months and 17 years (median 9 years; 48.8% females). At the peak of the disease 81.3% had abnormal BNP and 58.8% had troponin leak which reduced to 33.8% and 18.8% respectively at discharge with complete normalization by 6 weeks post-discharge. At admission 33.8% had systolic dysfunction, which improved to 11.3% at discharge with complete resolution by 2 weeks. Coronary artery abnormalities were seen in 17.5% during the illness with complete resolution by 2 weeks post discharge except one (1.9%) with persistent giant aneurysm at 1 year-follow up. CMR was performed at 6 months in 23 patient and demonstrated 4 patients with persistent late gadolinium enhancement (17.4%). Normal exercise capacity with no ectopy was seen in the 31 qualifying patients that underwent a GXT.Conclusions: There is significant heterogeneity in the cardiovascular manifestations of MIS-C. Although majority of the cardiovascular manifestations resolve within 6 weeks, diastolic dysfunction, CAA and myocardial scar may persist in a small subset of patients warranting a structured long-term follow-up strategy.

Retrospective study about clinical severity and epidemiological analysis of the SARS-CoV-2 Omicron subvariant lineage-infected patients in Hohhot, China

“…In survivors, most people recovered, and some patients showed long-term symptoms, commonly referred to Post-Covid Syndromes [39,40] . Numerous studies have shown that the risk of cardiovascular disease, including heart attack and stroke, increased signi cantly over a long period of time after the patients infected with Omicron BF.7, these symptoms can cause myocarditis, heart attack, cardiac arrest and sudden death and so on [41][42][43][44] . The patients could include outpatients and asymptomatic patients under the age of 50.…”

Cardiac MRI with late gadolinium enhancement shows cardiac involvement 3–6 months after severe acute COVID-19 similar to or worse than PIMS

“…Data on secondary damage to the cardiovascular system varies depending on the utilized techniques, parameters, and follow-up period. Results range from complete remission to 36% measurable long-term damage (2)(3)(4)(5).…”

Using Social Media to Help Understand Long COVID Patient Reported Health Outcomes: A Natural Language Processing Approach

“…Multiple pioneering efforts have investigated symptoms of long COVID for hospitalized individuals, representing the minority of people with COVID-19 [5]- [7]. An extensive patient-led survey has been conducted in an outpatient setting to explore the symptoms of long COVID over seven months [3].…”