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Reduced aerobic capacity in children with multisystem inflammatory syndrome in children (MIS-C) after PICU admission:
Albane B R Maggio1, Sofia Palomo2, Raphael Joye3
1Health and movement consultation, Division of Paediatric Specialties, Department of paediatrics, gynaecology and obstetrics, Geneva University Hospital and University of Geneva, Boulevard de la Cluse 26, Geneva 14, 1211, Switzerland.
Insights
Children diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C) show reduced aerobic capacity and muscular deconditioning compared to healthy peers. This highlights the need for targeted physical rehabilitation post-illness.
Area of Science:
- Pediatric Cardiology
- Intensive Care Medicine
- Exercise Physiology
Background:
- Multisystem Inflammatory Syndrome in Children (MIS-C) is a serious condition affecting multiple organs.
- The long-term effects of MIS-C on pediatric physical fitness are not well understood.
- Aerobic capacity is a crucial indicator of overall health and physical function in children.
Purpose of the Study:
- To compare aerobic capacity in children and adolescents diagnosed with MIS-C versus healthy controls.
- To identify potential markers of impaired physical function post-MIS-C.
- To assess the degree of muscular deconditioning in MIS-C survivors.
Main Methods:
- Prospective cohort study involving 14 children with MIS-C and 70 healthy controls.
- Cardiopulmonary exercise testing to measure maximum oxygen uptake (VO2max) and ventilatory anaerobic threshold (VAT).
- Assessment conducted at post-intensive care unit follow-up, approximately 3.6 months after diagnosis.
Main Results:
- Children with MIS-C had significantly lower VO2max Z-scores and VAT Z-scores compared to healthy controls.
- A higher proportion of MIS-C patients exhibited impaired aerobic capacity (VO2max Z-score < -1.64) and impaired VAT (VAT Z-score < -1.64).
- Impaired aerobic capacity in MIS-C was associated with higher BMI, higher PELOD 2 score, lower platelet count at admission, and lower hemoglobin levels.
Conclusions:
- Children with MIS-C experience significant reductions in aerobic capacity, likely due to muscular deconditioning.
- These findings underscore the importance of evaluating and addressing physical deconditioning in MIS-C survivors.
- Post-ICU consultations and rehabilitation strategies are crucial for this pediatric population.
Objective:
This study aimed to evaluate aerobic capacity in children and adolescents following a diagnosis of Multisystem Inflammatory Syndrome in Children (MIS-C) compared to healthy matched controls.
Design:
Prospective cohort study.
Setting:
Quaternary Pediatric intensive care unit and Pediatric cardiology unit.
Participants:
14 children diagnosed with MIS-C.
Interventions:
None.
Measurements:
Cardiopulmonary fitness parameters at the time of post-Pediatric intensive care unit follow-up (mean 3.6 months) such as maximum oxygen uptake (VO2max) and the first ventilatory anaerobic threshold (VAT), as a marker of muscular deconditioning.
Main Results:
A total of 14 patients (12 boys) with a confirmed diagnosis of MIS-C and 70 healthy children were included. The median age was 13.2 years (range 10.7-13.6 years). All participants had a normal echocardiogram and normal lung function at the time of cardiopulmonary exercise test. As measured by VO2max Z-score, exercise capacity was significantly lower in the MIS-C group compared to healthy controls (median-0.91 vs 0.13, p < 0.01), and a significantly higher proportion of children in the MIS-C group had impaired aerobic capacity (VO2max Z-score<-1.64) compared to controls (29% vs. 3%, p < 0.01). The VAT was also significantly lower in the MIS-C group with a higher proportion of children with an impaired VAT (VAT Z-score<-1.64) compared to controls (43% vs. 3%, p = 0.03). Impaired aerobic capacity in the MIS-C group was associated with higher BMI, higher PELOD 2 score and lower platelet count at the PICU admission, and lower hemoglobin level at the cardiopulmonary exercise test time.
Conclusions:
This study suggests that children with MIS-C experience significant reductions in aerobic capacity compared to healthy controls, primarily due to muscular deconditioning. These findings highlight the importance of considering post-ICU consultations and implementing strategies to address physical deconditioning in this population.
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