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Cardiac Outcome of Children With SARS-CoV-2 Related Multisystem Inflammatory Syndrome
Ali Reza Ghodsi1, Abdolreza Malek2, Soheila Siroosbakht1
1Department of Pediatrics, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran.
Insights
Most children with multisystem inflammatory syndrome (MIS-C) showed cardiac abnormalities at diagnosis, but this significantly improved by six months. Early treatment with IVIG and steroids reduced the risk of cardiac dysfunction in MIS-C patients.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Inflammatory Syndromes
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a serious condition linked to COVID-19.
- Cardiac involvement is common in MIS-C, necessitating detailed follow-up studies.
Approach:
- This study reviewed hospital records of 116 MIS-C patients (<21 years) with six-month follow-up.
- Echocardiographic findings were analyzed at baseline and six months post-diagnosis.
- Demographic, clinical, laboratory, and treatment data were collected.
Key Points:
- At diagnosis, 70.7% of MIS-C patients had cardiac abnormalities, including valve failure (50.9%) and ventricular dysfunction (39.7%).
- By six months, only 10.3% of patients had persistent cardiac abnormalities.
- Treatment with IVIG and steroids significantly reduced the likelihood of ventricular dysfunction, valve failure, and low ejection fraction compared to IVIG alone.
Conclusions:
- Cardiac abnormalities in MIS-C patients significantly decrease within six months of diagnosis.
- Early intervention with IVIG and steroids appears crucial in mitigating long-term cardiac complications in MIS-C.
Objective:
To study the cardiac outcomes of patients with multisystem inflammatory syndrome in children (MIS-C) after 6-month of diagnosis.
Methods:
This review of hospital records was conducted on MIS-C patients (aged <21 year) who completed a six-month follow up. The baseline demographic, clinical, laboratory, and treatment characteristics during the acute phase, and echocardiographic findings during follow-up were collected.
Results:
116 patients (61.2% male, median age 7 years) with MIS-C were included in the study. At the time of admission, cardiac abnormalities were present in 70.7% of MIS-C patients, and the most common cardiac abnormalities were valve failure (50.9%), followed by ventricular dysfunction (39.7%), and pericardial effusion (23.3%). Six month after diagnosis, cardiac abnormalities were found in 10.3% of patients, and patients had lower rates of ventricular dysfunction (P<0.001), valve failure (P<0.001), pericardial effusion (P<0.001), and coronary involvement (P<0.001) as composed to the baseline. Intravenous immunoglobulin (IVIG) and steroid treatment significantly reduced the odds of occurrence of ventricular dysfunction (P=0.002), valve failure (P=0.004), and low ejection fraction (P=0.002) in comparison to IVIG treatment.
Conclusion:
While most MIS-C patients had abnormal echocardiographic findings at admission, only 10.3% of patients had cardiac abnormalities during follow up.
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