Medium-Term Cardiac Outcomes in Young People with Multi-system Inflammatory Syndrome: The Era of COVID-19

• Published in: Pediatric cardiology 2022-12, Vol.43 (8), p.1728-1736
• Main Authors: Wong, James, Theocharis, Paraskevi, Regan, William, Pushparajah, Kuberan, Stephenson, Natasha, Pascall, Emma, Cleary, Aoife, O’Byrne, Laura, Savis, Alex, Miller, Owen
• Format: Article
• Language: English
• Subjects: Adolescent; Aneurysms; Cardiac Surgery; Cardiology; Child; Coronary Aneurysm - etiology; Coronavirus Infections - complications; COVID-19; Electrocardiogram; Electrocardiography; Heart; Humans; Inflammation; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Original; Original Article; Pericardial Effusion; Retrospective Studies; Systemic Inflammatory Response Syndrome - complications; Teenagers; Vascular Surgery; Youth
• ISSN: 0172-0643; 1432-1971; 1432-1971
• DOI: 10.1007/s00246-022-02907-y

Multi-system inflammatory syndrome in children (MIS-C) causes widespread inflammation including a pancarditis in the weeks following a COVID infection. As we prepare for further coronavirus surges, understanding the medium-term cardiac impacts of this condition is important for allocating healthcare resources. A retrospective single-center study of 67 consecutive patients with MIS-C was performed evaluating echocardiographic and electrocardiographic (ECG) findings to determine the point of worst cardiac dysfunction during the admission, then at intervals of 6–8 weeks and 6–8 months. Worst cardiac function occurred 6.8 ± 2.4 days after the onset of fever with mean 3D left ventricle (LV) ejection fraction (EF) 50.5 ± 9.8%. A pancarditis was typically present: 46.3% had cardiac impairment; 31.3% had pericardial effusion; 26.8% demonstrated moderate (or worse) valvar regurgitation; and 26.8% had coronary dilatation. Cardiac function normalized in all patients by 6–8 weeks (mean 3D LV EF 61.3 ± 4.4%, p