One-Year Follow-Up Results of MIS-C Patients with Coronary Artery Involvement: A Multi-center Study

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Echocardiography

Background:

• Multisystem inflammatory syndrome in children (MIS-C) is a rare but serious complication of SARS-CoV-2 infection.
• Coronary artery abnormalities are a significant concern in MIS-C, impacting long-term prognosis and management.
• Understanding the natural course of coronary artery involvement is crucial for pediatric patient care.

Purpose of the Study:

• To analyze the one-year echocardiographic changes in coronary arteries of children diagnosed with MIS-C.
• To categorize and track the progression of coronary artery pathologies, including increased echogenicity, dilatation, and aneurysm.
• To evaluate the recovery rates and long-term outcomes of coronary artery involvement in MIS-C patients.

Main Methods:

• A multicenter, retrospective study analyzing data from nine centers between May 2020 and August 2022.
• Inclusion of 790 pediatric patients with MIS-C, with a focus on the 68 who exhibited coronary artery involvement.
• One-year echocardiographic data of 67 patients were analyzed, categorizing pathologies by Z scores and tracking changes over time.

Main Results:

• Coronary artery involvement was observed in 68 of 790 MIS-C patients (8.6%).
• Pathologies included aneurysm (16.4%), dilatation (68.7%), and increased echogenicity (13.4%).
• Increased echogenicity resolved by one month; dilatation showed no progression to aneurysm or worsening by six months. At least 94% normalized by 12 months.

Conclusions:

• Coronary artery involvement in MIS-C demonstrates a generally favorable one-year prognosis with high rates of normalization.
• Early echogenicity changes resolve quickly, and dilatation typically does not progress to aneurysm.
• Long-term follow-up indicates significant recovery, supporting current management strategies for MIS-C-related coronary artery issues.