tetano
Editor, Senior Moderator
World J Pediatr
. 2023 May 1.
doi: 10.1007/s12519-023-00722-w. Online ahead of print. Significant exercise limitations after recovery from MIS-C related myocarditis
Gur Mainzer[SUP] 1 2 3 [/SUP], Merav Zucker-Toledano[SUP] 4 [/SUP], Moneera Hanna[SUP] 5 [/SUP], Ronen Bar-Yoseph[SUP] 5 6 [/SUP], Einat Kodesh[SUP] 7 8 [/SUP]
Affiliations
Background: Myocarditis is one of the presentations of multisystemic inflammatory syndrome in children (MIS-C) following coronavirus disease 2019 (COVID-19). Although the reported short-term prognosis is good, data regarding medium-term functional capacity and limitations are scarce. This study aimed to evaluate exercise capacity as well as possible cardiac and respiratory limitations in children recovered from MIS-C related myocarditis.
Methods: Fourteen patients who recovered from MIS-C related myocarditis underwent spirometry and cardiopulmonary exercise testing (CPET), and their results were compared with an age-, sex-, weight- and activity level-matched healthy control group (n = 14).
Results: All participants completed the CPET with peak oxygen uptake (peak [Formula: see text]), and the results were within the normal range (MIS-C 89.3% ± 8.9% and Control 87.9% ± 13.7% predicted [Formula: see text]). Five post-MIS-C patients (35%) had exercise-related cardio-respiratory abnormalities, including oxygen desaturation and oxygen-pulse flattening, compared to none in the control group. The MIS-C group also had lower peak exercise saturation (95.6 ± 3.5 vs. 97.6 ± 1.1) and lower breathing reserve (17.4% ± 7.5% vs. 27.4% ± 14.0% of MVV).
Conclusions: Patients who recovered from MIS-C related myocarditis may present exercise limitations. Functional assessment (e.g., CPET) should be included in routine examinations before allowing a return to physical activity in post-MIS-C myocarditis. Larger, longer term studies assessing functional capacity and focusing on physiological mechanisms are needed.
Keywords: COVID 19; Cardiopulmonary exercise testing; Hypoxemia; Myocarditis.
. 2023 May 1.
doi: 10.1007/s12519-023-00722-w. Online ahead of print. Significant exercise limitations after recovery from MIS-C related myocarditis
Gur Mainzer[SUP] 1 2 3 [/SUP], Merav Zucker-Toledano[SUP] 4 [/SUP], Moneera Hanna[SUP] 5 [/SUP], Ronen Bar-Yoseph[SUP] 5 6 [/SUP], Einat Kodesh[SUP] 7 8 [/SUP]
Affiliations
- PMID: 37127785
- DOI: 10.1007/s12519-023-00722-w
Background: Myocarditis is one of the presentations of multisystemic inflammatory syndrome in children (MIS-C) following coronavirus disease 2019 (COVID-19). Although the reported short-term prognosis is good, data regarding medium-term functional capacity and limitations are scarce. This study aimed to evaluate exercise capacity as well as possible cardiac and respiratory limitations in children recovered from MIS-C related myocarditis.
Methods: Fourteen patients who recovered from MIS-C related myocarditis underwent spirometry and cardiopulmonary exercise testing (CPET), and their results were compared with an age-, sex-, weight- and activity level-matched healthy control group (n = 14).
Results: All participants completed the CPET with peak oxygen uptake (peak [Formula: see text]), and the results were within the normal range (MIS-C 89.3% ± 8.9% and Control 87.9% ± 13.7% predicted [Formula: see text]). Five post-MIS-C patients (35%) had exercise-related cardio-respiratory abnormalities, including oxygen desaturation and oxygen-pulse flattening, compared to none in the control group. The MIS-C group also had lower peak exercise saturation (95.6 ± 3.5 vs. 97.6 ± 1.1) and lower breathing reserve (17.4% ± 7.5% vs. 27.4% ± 14.0% of MVV).
Conclusions: Patients who recovered from MIS-C related myocarditis may present exercise limitations. Functional assessment (e.g., CPET) should be included in routine examinations before allowing a return to physical activity in post-MIS-C myocarditis. Larger, longer term studies assessing functional capacity and focusing on physiological mechanisms are needed.
Keywords: COVID 19; Cardiopulmonary exercise testing; Hypoxemia; Myocarditis.