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Cardiol Young . Cardiac manifestations and short-term outcomes of Multisystem Inflammatory Syndrome in Middle Eastern Children during the COVID-19 pandemic: A case series

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  • Cardiol Young . Cardiac manifestations and short-term outcomes of Multisystem Inflammatory Syndrome in Middle Eastern Children during the COVID-19 pandemic: A case series


    Cardiol Young


    . 2021 Jun 17;1-13.
    doi: 10.1017/S1047951121002614. Online ahead of print.
    Cardiac manifestations and short-term outcomes of Multisystem Inflammatory Syndrome in Middle Eastern Children during the COVID-19 pandemic: A case series


    Theresia E Tannoury 1 , Ziad R Bulbul 1 , Fadi F Bitar 1



    Affiliations

    Abstract

    We herein report on a series of 4 patients presented to our tertiary care center with features of multisystem inflammatory syndrome in children (MIS-C) and cardiac involvement. Two of our patients had recent exposure to a COVID-19 positive patient, 1 had recent documented infection, and another had no known positive contact. All patients tested positive for Severe acute respiratory syndrome coronavirus 2 Immunoglobulin G (SARS-CoV-2 IgG) antibody at the time of presentation. All of them fulfilled the diagnostic criteria according to World Health Organization Centers for Disease Control or the British guidelines for MISC (fever for ≥3 days, multisystem involvement (at least 2), elevated markers of inflammation and no other alternative diagnosis). (1, 2,3)Cardiac involvement was variable ranging from isolated ectasia of the coronary arteries to full blown pan-carditis: severe biventricular dysfunction, multi-valvar involvement, and pericardial effusion.All our patient received Intravenous immunoglobulin IVIG (2 g/kg), methylprednisolone, and aspirin and some required inotropic support and ICU admission.Remarkably, all our patients showed significant improvement in their cardiac disease within few days as evident on serial echocardiographic evaluation. However, we stress the need for long term follow up as one of our patients demonstrated mild LV myocardial scarring as evident by gadolinium late enhancement on a Cardiac MRI.

    Keywords: COVID-19; Cardiac manifestations; coronary involvement; multisystem inflammatory syndrome in children (MIS-C); myocardial dysfunction.

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