tetano
Editor, Senior Moderator
Cardiol Young
. 2021 Aug 5;1-9.
doi: 10.1017/S1047951121003024. Online ahead of print.
Cardiac echocardiogram findings of severe acute respiratory syndrome coronavirus-2-associated multi-system inflammatory syndrome in children
Ashraf S Harahsheh[SUP] 1 2 [/SUP], Anita Krishnan[SUP] 1 2 [/SUP], Roberta L DeBiasi[SUP] 2 3 4 [/SUP], Laura J Olivieri[SUP] 1 2 [/SUP], Christopher Spurney[SUP] 1 2 [/SUP], Mary T Donofrio[SUP] 1 2 [/SUP], Russell R Cross[SUP] 1 2 [/SUP], Matthew P Sharron[SUP] 2 5 [/SUP], Lowell H Frank[SUP] 1 2 [/SUP], Charles I Berul[SUP] 1 2 [/SUP], Adam Christopher[SUP] 1 [/SUP], Niti Dham[SUP] 1 2 [/SUP], Hemalatha Srinivasalu[SUP] 2 6 [/SUP], Tova Ronis[SUP] 2 6 [/SUP], Karen L Smith[SUP] 2 7 [/SUP], Jaclyn N Kline[SUP] 2 8 [/SUP], Kavita Parikh[SUP] 2 7 [/SUP], David Wessel[SUP] 1 2 [/SUP], James E Bost[SUP] 1 2 [/SUP], Sarah Litt[SUP] 1 [/SUP], Ashley Austin[SUP] 1 [/SUP], Jing Zhang[SUP] 1 [/SUP], Craig A Sable[SUP] 1 2 [/SUP]
Affiliations
Abstract
Background: A novel paediatric disease, multi-system inflammatory syndrome in children, has emerged during the 2019 coronavirus disease pandemic.
Objectives: To describe the short-term evolution of cardiac complications and associated risk factors in patients with multi-system inflammatory syndrome in children.
Methods: Retrospective single-centre study of confirmed multi-system inflammatory syndrome in children treated from 29 March, 2020 to 1 September, 2020. Cardiac complications during the acute phase were defined as decreased systolic function, coronary artery abnormalities, pericardial effusion, or mitral and/or tricuspid valve regurgitation. Patients with or without cardiac complications were compared with chi-square, Fisher's exact, and Wilcoxon rank sum.
Results: Thirty-nine children with median (interquartile range) age 7.8 (3.6-12.7) years were included. Nineteen (49%) patients developed cardiac complications including systolic dysfunction (33%), valvular regurgitation (31%), coronary artery abnormalities (18%), and pericardial effusion (5%). At the time of the most recent follow-up, at a median (interquartile range) of 49 (26-61) days, cardiac complications resolved in 16/19 (84%) patients. Two patients had persistent mild systolic dysfunction and one patient had persistent coronary artery abnormality. Children with cardiac complications were more likely to have higher N-terminal B-type natriuretic peptide (p = 0.01), higher white blood cell count (p = 0.01), higher neutrophil count (p = 0.02), severe lymphopenia (p = 0.05), use of milrinone (p = 0.03), and intensive care requirement (p = 0.04).
Conclusion: Patients with multi-system inflammatory syndrome in children had a high rate of cardiac complications in the acute phase, with associated inflammatory markers. Although cardiac complications resolved in 84% of patients, further long-term studies are needed to assess if the cardiac abnormalities (transient or persistent) are associated with major cardiac events.
Keywords: 2019 coronavirus disease pandemic; Paediatric multisystem inflammatory syndrome temporally associated with 2019 coronavirus disease; coronary artery; multi-system inflammatory syndrome in children; myocarditis; paediatric cardiology.
. 2021 Aug 5;1-9.
doi: 10.1017/S1047951121003024. Online ahead of print.
Cardiac echocardiogram findings of severe acute respiratory syndrome coronavirus-2-associated multi-system inflammatory syndrome in children
Ashraf S Harahsheh[SUP] 1 2 [/SUP], Anita Krishnan[SUP] 1 2 [/SUP], Roberta L DeBiasi[SUP] 2 3 4 [/SUP], Laura J Olivieri[SUP] 1 2 [/SUP], Christopher Spurney[SUP] 1 2 [/SUP], Mary T Donofrio[SUP] 1 2 [/SUP], Russell R Cross[SUP] 1 2 [/SUP], Matthew P Sharron[SUP] 2 5 [/SUP], Lowell H Frank[SUP] 1 2 [/SUP], Charles I Berul[SUP] 1 2 [/SUP], Adam Christopher[SUP] 1 [/SUP], Niti Dham[SUP] 1 2 [/SUP], Hemalatha Srinivasalu[SUP] 2 6 [/SUP], Tova Ronis[SUP] 2 6 [/SUP], Karen L Smith[SUP] 2 7 [/SUP], Jaclyn N Kline[SUP] 2 8 [/SUP], Kavita Parikh[SUP] 2 7 [/SUP], David Wessel[SUP] 1 2 [/SUP], James E Bost[SUP] 1 2 [/SUP], Sarah Litt[SUP] 1 [/SUP], Ashley Austin[SUP] 1 [/SUP], Jing Zhang[SUP] 1 [/SUP], Craig A Sable[SUP] 1 2 [/SUP]
Affiliations
- PMID: 34348808
- DOI: 10.1017/S1047951121003024
Abstract
Background: A novel paediatric disease, multi-system inflammatory syndrome in children, has emerged during the 2019 coronavirus disease pandemic.
Objectives: To describe the short-term evolution of cardiac complications and associated risk factors in patients with multi-system inflammatory syndrome in children.
Methods: Retrospective single-centre study of confirmed multi-system inflammatory syndrome in children treated from 29 March, 2020 to 1 September, 2020. Cardiac complications during the acute phase were defined as decreased systolic function, coronary artery abnormalities, pericardial effusion, or mitral and/or tricuspid valve regurgitation. Patients with or without cardiac complications were compared with chi-square, Fisher's exact, and Wilcoxon rank sum.
Results: Thirty-nine children with median (interquartile range) age 7.8 (3.6-12.7) years were included. Nineteen (49%) patients developed cardiac complications including systolic dysfunction (33%), valvular regurgitation (31%), coronary artery abnormalities (18%), and pericardial effusion (5%). At the time of the most recent follow-up, at a median (interquartile range) of 49 (26-61) days, cardiac complications resolved in 16/19 (84%) patients. Two patients had persistent mild systolic dysfunction and one patient had persistent coronary artery abnormality. Children with cardiac complications were more likely to have higher N-terminal B-type natriuretic peptide (p = 0.01), higher white blood cell count (p = 0.01), higher neutrophil count (p = 0.02), severe lymphopenia (p = 0.05), use of milrinone (p = 0.03), and intensive care requirement (p = 0.04).
Conclusion: Patients with multi-system inflammatory syndrome in children had a high rate of cardiac complications in the acute phase, with associated inflammatory markers. Although cardiac complications resolved in 84% of patients, further long-term studies are needed to assess if the cardiac abnormalities (transient or persistent) are associated with major cardiac events.
Keywords: 2019 coronavirus disease pandemic; Paediatric multisystem inflammatory syndrome temporally associated with 2019 coronavirus disease; coronary artery; multi-system inflammatory syndrome in children; myocarditis; paediatric cardiology.