tetano
Editor, Senior Moderator
Cardiol Young
. 2022 Mar 24;1-9.
doi: 10.1017/S1047951122000828. Online ahead of print.
Short to midterm follow-up of multi-system inflammatory syndrome in children with special reference to cardiac involvement
Omeir A Aziz[SUP] 1 [/SUP], Masood Sadiq[SUP] 1 [/SUP], Ahmad U Qureshi[SUP] 1 [/SUP], Najam Hyder[SUP] 1 [/SUP], Uzma Kazmi[SUP] 1 [/SUP], Afsheen Batool[SUP] 2 [/SUP], Samia Naz[SUP] 2 [/SUP], Asma Mushtaq[SUP] 2 [/SUP], Attia Bari[SUP] 2 [/SUP], Junaid Rashid[SUP] 2 [/SUP]
Affiliations
Abstract
Objectives: We aim to describe the early and upto 16 months follow-up of post-coronavirus disease (COVID), multi-system inflammatory syndrome in children (MIS-C), with special reference to cardiac involvement.
Study design: This cohort non-interventional descriptive study included patients <18 years admitted between May, 2020 and April, 2021. Based on underlying similarities, children were classified as post-COVID MIS-C with overlapping Kawasaki Disease, MIS-C with no overlapping Kawasaki Disease, and MIS-C with shock. Post-discharge, patients were followed at 1, 3, 6, 12, and 16 months.
Results: Forty-one patients predominantly males (73%), at median age of 7 years (range 0.2-16 years) fulfilled the World Health Organisation criteria for MIS-C. Cardiac involvement was seen in 15 (36.5%); impaired left ventricle (LV) function in 5 (12.2%), coronary artery involvement in 10 (24.4%), pericardial effusion in 6 (14.6%) patients, and no arrhythmias. There were two hospital deaths (4.9%), both in MIS-C shock subgroup (2/10, 20%). At 1 month, there was persistent LV dysfunction in 2/5, coronary artery abnormalities in 7/10, and pericardial effusion resolved completely in all patients. By 6 months, LV function returned to normal in all but coronary abnormalities persisted in two patients. At last follow-up (median 9.8 months, interquartile range 2-16 months), in 36/38 (94.7%) patients, coronary artery dilatation was persistent in 2 (20%) patients.
Conclusions: Children with MIS-C have a good early outcome, though MIS-C with shock can be life-threatening subgroup in a resource-constrained country setting. On midterm follow-up, there is normalisation of LV function in all and recovery of coronary abnormalities in 80% of patients.
Keywords: COVID-19; Multi-system inflammatory syndrome in children; SARS-CoV-2; coronary artery aneurysms.
. 2022 Mar 24;1-9.
doi: 10.1017/S1047951122000828. Online ahead of print.
Short to midterm follow-up of multi-system inflammatory syndrome in children with special reference to cardiac involvement
Omeir A Aziz[SUP] 1 [/SUP], Masood Sadiq[SUP] 1 [/SUP], Ahmad U Qureshi[SUP] 1 [/SUP], Najam Hyder[SUP] 1 [/SUP], Uzma Kazmi[SUP] 1 [/SUP], Afsheen Batool[SUP] 2 [/SUP], Samia Naz[SUP] 2 [/SUP], Asma Mushtaq[SUP] 2 [/SUP], Attia Bari[SUP] 2 [/SUP], Junaid Rashid[SUP] 2 [/SUP]
Affiliations
- PMID: 35321771
- DOI: 10.1017/S1047951122000828
Abstract
Objectives: We aim to describe the early and upto 16 months follow-up of post-coronavirus disease (COVID), multi-system inflammatory syndrome in children (MIS-C), with special reference to cardiac involvement.
Study design: This cohort non-interventional descriptive study included patients <18 years admitted between May, 2020 and April, 2021. Based on underlying similarities, children were classified as post-COVID MIS-C with overlapping Kawasaki Disease, MIS-C with no overlapping Kawasaki Disease, and MIS-C with shock. Post-discharge, patients were followed at 1, 3, 6, 12, and 16 months.
Results: Forty-one patients predominantly males (73%), at median age of 7 years (range 0.2-16 years) fulfilled the World Health Organisation criteria for MIS-C. Cardiac involvement was seen in 15 (36.5%); impaired left ventricle (LV) function in 5 (12.2%), coronary artery involvement in 10 (24.4%), pericardial effusion in 6 (14.6%) patients, and no arrhythmias. There were two hospital deaths (4.9%), both in MIS-C shock subgroup (2/10, 20%). At 1 month, there was persistent LV dysfunction in 2/5, coronary artery abnormalities in 7/10, and pericardial effusion resolved completely in all patients. By 6 months, LV function returned to normal in all but coronary abnormalities persisted in two patients. At last follow-up (median 9.8 months, interquartile range 2-16 months), in 36/38 (94.7%) patients, coronary artery dilatation was persistent in 2 (20%) patients.
Conclusions: Children with MIS-C have a good early outcome, though MIS-C with shock can be life-threatening subgroup in a resource-constrained country setting. On midterm follow-up, there is normalisation of LV function in all and recovery of coronary abnormalities in 80% of patients.
Keywords: COVID-19; Multi-system inflammatory syndrome in children; SARS-CoV-2; coronary artery aneurysms.