Related Experiment Video
Updated: Aug 1, 2025
Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding
Published on: August 30, 2024
Six-month cardiac outcomes in children with multisystem inflammatory syndrome in children
Joshua Kaltman1, Rohali Keesari1, Rohit Madani1,2
1Emory University School of Medicine, Atlanta, GA, USA.
Insights
Multisystem inflammatory syndrome in children (MIS-C) can cause cardiac issues, but most symptoms improve within weeks. A small number of children may experience persistent coronary artery abnormalities following MIS-C.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Critical Care Medicine
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a rare post-infectious complication of SARS-CoV-2.
- Long-term sequelae, especially cardiac, require further investigation in diverse pediatric populations.
Purpose of the Study:
- To assess the long-term cardiac sequelae in a large, diverse cohort of children diagnosed with MIS-C.
Main Methods:
- Retrospective cohort study of 304 children (0-20 years) with MIS-C.
- Data collected at hospitalization and follow-up visits (2 weeks to 1 year).
- Cardiovascular outcomes included echocardiogram, left ventricular ejection fraction, pericardial effusion, coronary artery abnormalities, and ECG.
Main Results:
- At hospitalization, 57.2% had abnormal echocardiograms, 10.6% coronary abnormalities, and 19.6% abnormal ECGs.
- Cardiac abnormalities significantly improved by 2-6 weeks post-diagnosis.
- A small subset of patients showed persistent coronary abnormalities.
Conclusions:
- Children with MIS-C exhibit significant acute cardiac abnormalities that typically resolve within weeks.
- Persistent coronary abnormalities are a potential long-term sequela in a subset of MIS-C patients.
Background:
Multisystem inflammatory syndrome in children is a rare, post-infectious complication of SARS-CoV-2 infection in children. We aimed to assess the long-term sequelae, particularly cardiac, in a large, diverse population.
Methods:
We performed a retrospective cohort study of all children (aged 0-20 years, n = 304) admitted to a tertiary care centre with a diagnosis of multisystem inflammatory syndrome in children from March 1, 2020 to August 31, 2021 and had at least one follow-up visit through December 31, 2021. Data were collected at hospitalisation, 2 weeks, 6 weeks, 3 months, and 1 year after diagnosis, where applicable. Cardiovascular outcomes included left ventricular ejection fraction, presence or absence of pericardial effusion, coronary artery abnormalities, and abnormal electrocardiogram findings.
Results:
Population was median age 9 years (IQR 5-12), 62.2% male, 61.8% African American (AA), and 15.8% Hispanic. Hospitalisation findings included abnormal echocardiogram 57.2%, mean worst recorded left ventricular ejection fraction 52.4% ± 12.4%, non-trivial pericardial effusion 13.4%, coronary artery abnormalities 10.6%, and abnormal ECG 19.6%. During follow-up, abnormal echocardiogram significantly decreased to 6.0% at 2 weeks and 4.7% at 6 weeks. Mean left ventricular ejection fraction significantly increased to 65.4% ± 5.6% at 2 weeks and stabilised. Pericardial effusion significantly decreased to 3.2% at 2 weeks and stabilised. Coronary artery abnormalities significantly decreased to 2.0% and abnormal electrocardiograms significantly decreased to 6.4% at 2 weeks and stabilised.
Conclusion:
Children with multisystem inflammatory syndrome in children have significant echocardiographic abnormalities during the acute presentation, but these findings typically improve within weeks. However, a small subset of patients may have persistent coronary abnormalities.
Related Concept Videos
01:14Myocarditis III: Medical Management
01:22Myocarditis IV: Nursing Management
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:27Myocarditis II: Clinical Features and Diagnostic Tests
01:18Endocarditis III: Medical Management