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Short to midterm follow-up of multi-system inflammatory syndrome in children with special reference to cardiac involvement

Part of: Infectious

Published online by Cambridge University Press:  24 March 2022

Omeir A. Aziz ,
Masood Sadiq Open the ORCID record for Masood Sadiq [Opens in a new window] ,
Ahmad U. Qureshi ,
Najam Hyder ,
Uzma Kazmi ,
Afsheen Batool ,
Samia Naz ,
Asma Mushtaq ,
Attia Bari  and
Junaid Rashid
Omeir A. Aziz
Affiliation:
Department of Paediatric Cardiology, The Children’s Hospital, University of Child Health Sciences, Lahore, Pakistan
Masood Sadiq*
Affiliation:
Department of Paediatric Cardiology, The Children’s Hospital, University of Child Health Sciences, Lahore, Pakistan
Ahmad U. Qureshi
Affiliation:
Department of Paediatric Cardiology, The Children’s Hospital, University of Child Health Sciences, Lahore, Pakistan
Najam Hyder
Affiliation:
Department of Paediatric Cardiology, The Children’s Hospital, University of Child Health Sciences, Lahore, Pakistan
Uzma Kazmi
Affiliation:
Department of Paediatric Cardiology, The Children’s Hospital, University of Child Health Sciences, Lahore, Pakistan
Afsheen Batool
Affiliation:
Department of Paediatrics, The Children’s Hospital, University of Child Health Sciences, Lahore, Pakistan
Samia Naz
Affiliation:
Department of Paediatrics, The Children’s Hospital, University of Child Health Sciences, Lahore, Pakistan
Asma Mushtaq
Affiliation:
Department of Paediatrics, The Children’s Hospital, University of Child Health Sciences, Lahore, Pakistan
Attia Bari
Affiliation:
Department of Paediatrics, The Children’s Hospital, University of Child Health Sciences, Lahore, Pakistan
Junaid Rashid
Affiliation:
Department of Paediatrics, The Children’s Hospital, University of Child Health Sciences, Lahore, Pakistan
*
Author for correspondence: Prof M. Sadiq, The Children’s Hospital, University of Child Health Sciences, Ferozepur Road, Lahore 54000, Pakistan. Tel: +92-429-9230614; Fax: +92-42-99230358. E-mail: [email protected]
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Abstract

Objectives:

We aim to describe the early and upto 16 months follow-up of post-coronavirus disease (COVID), multi-system inflammatory syndrome in children (MIS-C), with special reference to cardiac involvement.

Study design:

This cohort non-interventional descriptive study included patients <18 years admitted between May, 2020 and April, 2021. Based on underlying similarities, children were classified as post-COVID MIS-C with overlapping Kawasaki Disease, MIS-C with no overlapping Kawasaki Disease, and MIS-C with shock. Post-discharge, patients were followed at 1, 3, 6, 12, and 16 months.

Results:

Forty-one patients predominantly males (73%), at median age of 7 years (range 0.2–16 years) fulfilled the World Health Organisation criteria for MIS-C. Cardiac involvement was seen in 15 (36.5%); impaired left ventricle (LV) function in 5 (12.2%), coronary artery involvement in 10 (24.4%), pericardial effusion in 6 (14.6%) patients, and no arrhythmias. There were two hospital deaths (4.9%), both in MIS-C shock subgroup (2/10, 20%). At 1 month, there was persistent LV dysfunction in 2/5, coronary artery abnormalities in 7/10, and pericardial effusion resolved completely in all patients. By 6 months, LV function returned to normal in all but coronary abnormalities persisted in two patients. At last follow-up (median 9.8 months, interquartile range 2–16 months), in 36/38 (94.7%) patients, coronary artery dilatation was persistent in 2 (20%) patients.

Conclusions:

Children with MIS-C have a good early outcome, though MIS-C with shock can be life-threatening subgroup in a resource-constrained country setting. On midterm follow-up, there is normalisation of LV function in all and recovery of coronary abnormalities in 80% of patients.

Keywords

Multi-system inflammatory syndrome in childrenSARS-CoV-2COVID-19coronary artery aneurysms
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 3 , March 2023 , pp. 371 - 379
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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