tetano
Editor, Senior Moderator
Cardiol Young
. 2021 Jul 15;1-15.
doi: 10.1017/S1047951121003140. Online ahead of print.
Cardiac Implications of Multisystem Inflammatory Syndrome Associated with COVID-19 in Children under the age of Five Years
Shaimaa Rakha[SUP] 1 [/SUP], Ali Sobh[SUP] 2 [/SUP], Amira H Hager[SUP] 1 [/SUP], Mona Hafez[SUP] 1 [/SUP], Gehan Alsawah[SUP] 1 [/SUP], Mohamed Magdi Abuelkheir[SUP] 1 [/SUP], Mayada Sabry Zeid[SUP] 2 [/SUP], Mohamed Nahas[SUP] 3 [/SUP], Hala Elmarsafawy[SUP] 1 [/SUP]
Affiliations
Abstract
Background: Coronavirus disease 2019(COVID-19) is responsible for significant lung disease in adults. Despite mild manifestations in most children, multisystem inflammatory syndrome (MIS-C) associated with COVID-19 is well-described in older children with cardiac manifestations. However, MIS-C-related cardiac manifestations are not as well-described in younger children.
Methods: The study is a retrospective analysis of MIS-C patients under age 5 years admitted between May to November 2020 to a single-center. Included cases fulfilled the case definition of MIS-C according to RCPCH criteria with cardiac laboratory, ECG, or echocardiographic evidence of cardiac disease. Collected Data included patients' demographics, laboratory results, echocardiographic findings, management, and outcomes.
Results: Out of 16 MIS-C cases under 5 years, 10 (62.5%) had cardiac manifestations with a median age of 12 months, 9 (90%) were previously healthy. Cardiac manifestations included coronary arterial aneurysms or ectasia in 5 (50%) cases, 2 (20%) with isolated myopericarditis, coronary aneurysm with myocarditis in 2 (20%), and SVT in 1(10%). Intravenous immunoglobulins were given in all cases with coronary aneurysms or myocarditis. The median duration of hospitalization was 7(6-14) days; 2 (20%) cases with cardiac disease were mechanically ventilated and mortality in MIS-C cases below 5years was 12.5%. Normalization of systolic function occurred in half of the affected cases within one week and reached 100% by 30days of follow-up.
Conclusion: MIS-C associated with SARS-CoV-2 has a high possibility of serious associated cardiac manifestations in children under the age of 5years with mortality and/or long-term morbidities such as coronary aneurysms even in previously healthy pediatric patients.
Keywords: COVID-19; Cardiac; Multisystem Inflammatory Syndrome; under 5 years.
. 2021 Jul 15;1-15.
doi: 10.1017/S1047951121003140. Online ahead of print.
Cardiac Implications of Multisystem Inflammatory Syndrome Associated with COVID-19 in Children under the age of Five Years
Shaimaa Rakha[SUP] 1 [/SUP], Ali Sobh[SUP] 2 [/SUP], Amira H Hager[SUP] 1 [/SUP], Mona Hafez[SUP] 1 [/SUP], Gehan Alsawah[SUP] 1 [/SUP], Mohamed Magdi Abuelkheir[SUP] 1 [/SUP], Mayada Sabry Zeid[SUP] 2 [/SUP], Mohamed Nahas[SUP] 3 [/SUP], Hala Elmarsafawy[SUP] 1 [/SUP]
Affiliations
- PMID: 34261560
- DOI: 10.1017/S1047951121003140
Abstract
Background: Coronavirus disease 2019(COVID-19) is responsible for significant lung disease in adults. Despite mild manifestations in most children, multisystem inflammatory syndrome (MIS-C) associated with COVID-19 is well-described in older children with cardiac manifestations. However, MIS-C-related cardiac manifestations are not as well-described in younger children.
Methods: The study is a retrospective analysis of MIS-C patients under age 5 years admitted between May to November 2020 to a single-center. Included cases fulfilled the case definition of MIS-C according to RCPCH criteria with cardiac laboratory, ECG, or echocardiographic evidence of cardiac disease. Collected Data included patients' demographics, laboratory results, echocardiographic findings, management, and outcomes.
Results: Out of 16 MIS-C cases under 5 years, 10 (62.5%) had cardiac manifestations with a median age of 12 months, 9 (90%) were previously healthy. Cardiac manifestations included coronary arterial aneurysms or ectasia in 5 (50%) cases, 2 (20%) with isolated myopericarditis, coronary aneurysm with myocarditis in 2 (20%), and SVT in 1(10%). Intravenous immunoglobulins were given in all cases with coronary aneurysms or myocarditis. The median duration of hospitalization was 7(6-14) days; 2 (20%) cases with cardiac disease were mechanically ventilated and mortality in MIS-C cases below 5years was 12.5%. Normalization of systolic function occurred in half of the affected cases within one week and reached 100% by 30days of follow-up.
Conclusion: MIS-C associated with SARS-CoV-2 has a high possibility of serious associated cardiac manifestations in children under the age of 5years with mortality and/or long-term morbidities such as coronary aneurysms even in previously healthy pediatric patients.
Keywords: COVID-19; Cardiac; Multisystem Inflammatory Syndrome; under 5 years.