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Coronary Artery Changes in Patients with Multisystem Inflammatory Syndrome in Children: Los Angeles Experience
Justin Pick1, Mounica Y Rao1, Kathryn Dern1
1Division of Cardiology, Department of Pediatrics, Children's Hospital of Los Angeles, Los Angeles, CA.
Insights
Multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease showed increased cardiac issues during the COVID-19 pandemic. Early pandemic findings revealed higher rates of cardiac dysfunction and coronary aneurysms compared to pre-pandemic periods.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Cardiovascular Research
Background:
- Kawasaki disease is a leading cause of acquired pediatric heart disease.
- The 2020 coronavirus disease pandemic presented a novel global health challenge.
- Multisystem inflammatory syndrome in children (MIS-C) emerged as a new pediatric condition associated with COVID-19.
Observation:
- Cardiac findings in children with MIS-C and Kawasaki disease were compared during the early COVID-19 pandemic (2020) versus pre-pandemic years (2016-2019).
- A significant increase in coronary aneurysms was observed in 2020.
- Coronary involvement rates were similar, but cardiac dysfunction was more prevalent and severe.
Findings:
- Patients with MIS-C and Kawasaki disease during the initial pandemic phase exhibited a higher incidence of coronary aneurysms.
- Cardiac dysfunction, including reduced ejection fraction and increased inflammatory markers, was more common in the 2020 cohort.
- The volume and incidence of cardiac dysfunction were notably greater compared to the pre-pandemic period.
Implications:
- The findings highlight the significant cardiovascular impact of MIS-C and Kawasaki disease during the COVID-19 pandemic.
- Increased cardiac dysfunction necessitates vigilant monitoring and tailored management strategies for affected children.
- Further research is crucial to understand the long-term cardiovascular sequelae and optimize treatment protocols.
Abstract:
We compared cardiac findings in patients with multisystem inflammatory syndrome in children and Kawasaki disease in the first 6 months of the 2020 coronavirus disease pandemic to patients with Kawasaki disease during 2016-2019. We saw a high rate of coronary aneurysms in 2020, with a similar rate of coronary involvement but greater volume and incidence of cardiac dysfunction compared with previous years.