Cardiac Findings in Pediatric Patients With Multisystem Inflammatory Syndrome in Children Associated With COVID-19

• Published in: Clinical pediatrics 2021-02, Vol.60 (2), p.119-126
• Main Authors: Minocha, Prashant K., Phoon, Colin K. L., Verma, Sourabh, Singh, Rakesh K.
• Format: Article
• Language: English
• Subjects: Brain natriuretic peptide; Calcium-binding protein; Cardiovascular Diseases - virology; Child; Child, Preschool; Children; Coronary artery disease; Coronaviridae; Coronaviruses; COVID-19; COVID-19 - complications; COVID-19 - epidemiology; Echocardiography; EKG; Electrocardiography; Female; Heart diseases; Heart rate; Humans; Infant; Inflammation; Male; Multisystem inflammatory syndrome in children; New York City - epidemiology; Patients; Pediatrics; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Systemic Inflammatory Response Syndrome - complications; Systemic Inflammatory Response Syndrome - epidemiology; Troponin; Ultrasonic imaging
• ISSN: 0009-9228; 1938-2707
• DOI: 10.1177/0009922820961771

Background The overall severity of cardiac disease secondary to acute SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) infection in children appears to be much lower when compared with adults. However, the newly described multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19) has been associated with cardiac complications. Methods We reviewed the clinical course and cardiac testing results in pediatric patients hospitalized with MIS-C at 2 large hospital systems in the New York City metropolitan area over a 3-month period. Results Of the 33 patients (median age 2.8 years) in the study cohort, 24 (73%) had at least one abnormality in cardiac testing: abnormal electrocardiogram (48%), elevated brain natriuretic peptide (43%), abnormal echocardiogram (30%), and/or elevated troponin (21%). Electrocardiogram and echocardiogram abnormalities all resolved by the 2-week outpatient follow-up cardiology visit. Conclusion While 73% of pediatric patients with MIS-C had evidence of abnormal cardiac testing on hospital admission in our study, all cardiac testing was normal by outpatient hospital discharge follow-up. Cardiac screening tests should be performed in all patients diagnosed with MIS-C given the high rate of abnormal cardiac findings in our study cohort.