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Vascular and blood pressure alterations in children two years after multisystem inflammatory syndrome
Weronika Woźniak-Szewczyk1, Piotr Skrzypczyk2, Michał Szyszka3
1Department of Pediatrics with Clinical Assessment Unit, Medical University of Warsaw, Warsaw, Poland.
Insights
Children with multisystem inflammatory syndrome (MIS-C) show lasting vascular and cardiac changes two years post-infection. These include higher blood pressure, endothelial dysfunction markers, and thickened arteries, underscoring the need for ongoing cardiovascular monitoring.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Vascular Biology
Background:
- Multisystem inflammatory syndrome in children (MIS-C) is a serious complication of SARS-CoV-2 infection.
- The long-term effects of MIS-C on cardiovascular health in children are not well understood.
- Early identification of cardiovascular sequelae is crucial for timely intervention.
Purpose of the Study:
- To assess subclinical cardiovascular changes in children two years after MIS-C.
- To evaluate endothelial dysfunction, arterial stiffness, and blood pressure in post-MIS-C patients.
- To identify potential correlations between MIS-C severity markers and long-term cardiovascular alterations.
Main Methods:
- Cross-sectional study of 42 children with MIS-C and 38 healthy controls.
- Comprehensive cardiovascular assessment including biomarkers (galectin-3, sVCAM-1, sICAM-1), pulse wave velocity, carotid intima-media thickness (cIMT), echocardiography, and blood pressure.
- Analysis of fasting glucose, troponin, NT-proBNP, and inflammatory markers.
Main Results:
- Post-MIS-C children exhibited elevated fasting glucose, endothelial dysfunction markers (sVCAM-1, galectin-3), and increased blood pressure compared to controls.
- A significantly higher prevalence of thickened cIMT was observed in the MIS-C group (29.3% vs. 3.1%).
- Certain MIS-C severity markers correlated with observed long-term cardiovascular changes.
Conclusions:
- Two years post-MIS-C, children experience persistent biochemical changes and circulatory system alterations.
- Findings emphasize the critical need for long-term cardiovascular surveillance in children recovering from MIS-C.
- This study highlights potential risks for future cardiovascular complications in this population.
Abstract:
Multisystem inflammatory syndrome in children (MIS-C) is a severe complication of SARS-CoV-2 infection. The long-term impact on vascular and cardiac health in post-MIS-C patients remains unclear. We aimed to evaluate subclinical cardiovascular changes in children two years after MIS-C. This cross-sectional study included 42 children diagnosed with MIS-C (29 boys, 13 girls, median age 10.7 years) and 38 age- and sex-matched healthy controls. Participants underwent comprehensive cardiovascular assessment, including biomarkers of endothelial dysfunction (galectin-3, sVCAM-1, sICAM-1), arterial damage (pulse wave velocity, carotid intima-media thickness [cIMT]), echocardiography, and blood pressure measurements. Compared to controls, children post-MIS-C had higher fasting glucose levels (RE = 0.79; 95% CI 0.68-0.89; p < 0.05), higher markers of endothelial dysfunction (sVCAM-1, RE = 0.64; 95% CI 0.52-0.77; p = 0.03; galectin-3, RE = 0.74; 95% CI 0.63-0.85; p < 0.001), and increased peripheral and central blood pressure (RE from 0.64 to 0.77; all p < 0.05). Thickened cIMT (> 95th percentile) was observed in 29.3% of post-MIS-C children versus 3.1% of controls (odds ratio 12.83, 95% CI 1.57-104.95, p = 0.004). Some MIS-C severity markers (troponin, NT-proBNP, inflammatory markers) correlated with long-term cardiovascular changes. Two years after MIS-C, children are exposed to long-term biochemical changes and alterations in the circulatory system. Our findings highlight the importance of long-term follow-up and cardiovascular monitoring in post-MIS-C children.
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