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Midterm cardiovascular outcomes in children with MIS-C compared to Kawasaki disease: a multicenter prospective cohort

Sappaya Khrongsrattha1, Chodchanok Vijarnsorn2, Kanokvalee Santimahakullert3

  • 1Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Scientific Reports
|November 29, 2025
PubMed

Insights

Multisystem inflammatory syndrome in children (MIS-C) causes temporary heart dysfunction, while Kawasaki disease (KD) leads to more midterm coronary abnormalities in children. Both conditions showed recovery in heart function but KD had more persistent coronary issues.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Immunology

Background:

  • Multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) share overlapping symptoms, raising concerns about long-term cardiovascular effects.
  • Understanding midterm cardiovascular sequelae in survivors of MIS-C and KD is crucial for patient management.

Purpose of the Study:

  • To prospectively compare midterm cardiovascular outcomes in children who survived MIS-C and KD.
  • To assess differences in left ventricular function and coronary artery abnormalities between MIS-C and KD survivors 1-3 years post-diagnosis.

Main Methods:

  • A multicenter prospective cohort study involving 122 children (66 MIS-C, 56 KD) with echocardiographic follow-up.
  • Assessment of left ventricular ejection fraction (LVEF), coronary abnormalities, and left ventricular global longitudinal strain (LVGLS) at 1-3 years post-diagnosis.
  • Comparison of baseline characteristics and midterm outcomes between the MIS-C and KD groups.

Main Results:

  • MIS-C patients were older at diagnosis and more frequently presented with initial left ventricular dysfunction (25.8%) compared to KD (0%).
  • All patients recovered normal LVEF by follow-up, but one MIS-C patient showed persistent subclinical impairment (abnormal LVGLS).
  • Coronary abnormalities significantly decreased in MIS-C (30% to 1.5%) but remained higher in KD (14.2%) at follow-up, including ectasia and aneurysms.

Conclusions:

  • MIS-C is associated with transient ventricular dysfunction but rare persistent coronary involvement.
  • Kawasaki disease carries a higher burden of midterm coronary abnormalities, despite preserved cardiac function and LVGLS.
  • Long-term cardiovascular monitoring is essential for survivors of both MIS-C and KD, with a focus on coronary health in KD patients.

Keywords:
Coronary aneurysmEchocardiographyKawasaki diseaseMIS-CMultisystem inflammatory syndromeVentricular dysfunction

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