Long-term Cardiovascular and Psychological Outcomes of Multisystem Inflammatory Syndrome in Children: A Prospective
Salu Mahato1, Sanjeev Hanumantacharya Naganur2, Nidhi Chauhan3
1Department of Pediatrics, Advanced Pediatric Centre.
Insights
Long-term follow-up shows children with Multisystem Inflammatory Syndrome (MIS-C) fully recover. Most regain normal heart function and social maturity, with few experiencing lasting coronary artery issues.
Area of Science:
- Pediatrics
- Infectious Diseases
- Cardiology
Background:
- Multisystem Inflammatory Syndrome in Children (MIS-C) typically has good short-term outcomes.
- Limited long-term follow-up data exists for MIS-C, especially from low- and middle-income countries.
Purpose of the Study:
- To evaluate the long-term clinical, cardiac, psychological, and social outcomes of children diagnosed with MIS-C.
- To provide crucial follow-up data from a low-resource setting.
Main Methods:
- Prospective follow-up study of 51 children with MIS-C at a tertiary care hospital in North India.
- Data collection included clinical assessment, echocardiography, and validated scales for anxiety, PTSD, and social maturity.
- Follow-up occurred 44 months post-discharge.
Main Results:
- During acute illness, common symptoms included fever, GI/mucocutaneous involvement, shock, and cardiac issues (47% myocardial dysfunction, 22% coronary abnormalities).
- At long-term follow-up, all patients showed normalized left ventricular ejection fraction and normal school/peer functioning.
- Only 12% had mild coronary artery abnormalities; no anxiety or PTSD symptoms were reported, and social maturity was age-appropriate.
Conclusions:
- Long-term outcomes for MIS-C are favorable, indicating complete recovery of cardiac function in most cases.
- A small percentage may have persistent mild coronary artery abnormalities.
- No significant long-term psychological or social deficits were observed.
Background:
Multisystem inflammatory syndrome in children (MIS-C) is associated with favorable short-term outcomes. However, long-term follow-up data are limited, particularly from low- and middle-income countries.
Methodology:
This prospective follow-up study was conducted at a tertiary care hospital in North India between November 2024 and September 2025, involving children (n = 51) admitted with MIS-C and discharged between September 2020 and August 2022. The data collected included the clinical profile, echocardiography (left ventricular ejection fraction and coronary artery diameters), Screen for Child Anxiety-Related Disorders scale, UCLA Post-traumatic Stress Disorder Reaction Index and Vineland Social Maturity Scale.
Results:
During the acute phase, common manifestations included fever, gastrointestinal and mucocutaneous involvement, shock, elevated inflammatory markers, myocardial dysfunction (47%) and coronary abnormalities (22%). At follow-up 44 (43-46) months after discharge, none had major clinical symptoms; all had normalized left ventricular ejection fraction, normal school performance and peer relationships; and only 12% had mild coronary artery abnormalities. There were no anxiety or post-traumatic stress disorder-related symptoms, and all had age-appropriate social maturity.
Conclusions:
Long-term outcomes of MIS-C are favorable, with complete recovery of myocardial function, persistent mild coronary abnormalities in a small proportion, no anxiety or post-traumatic stress disorder, and normal social maturation.
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