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Six-month cardiac outcomes in children with multisystem inflammatory syndrome in children

Published online by Cambridge University Press:  28 April 2023

Joshua Kaltman ,
Rohali Keesari ,
Rohit Madani ,
Preeti Jaggi  and
Matthew E. Oster Open the ORCID record for Matthew E. Oster [Opens in a new window]
Joshua Kaltman
Affiliation:
Emory University School of Medicine, Atlanta, GA, USA
Rohali Keesari
Affiliation:
Emory University School of Medicine, Atlanta, GA, USA
Rohit Madani
Affiliation:
Emory University School of Medicine, Atlanta, GA, USA Children’s Healthcare of Atlanta, Atlanta, GA, USA
Preeti Jaggi
Affiliation:
Emory University School of Medicine, Atlanta, GA, USA Children’s Healthcare of Atlanta, Atlanta, GA, USA
Matthew E. Oster*
Affiliation:
Emory University School of Medicine, Atlanta, GA, USA Children’s Healthcare of Atlanta, Atlanta, GA, USA
*
Corresponding author: Dr Matthew Oster, MD, MPH, Emory University School of Medicine, 1405 Clifton Road, Atlanta, GA 30322, USA. E-mail: osterm@kidsheart.com
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Abstract

Background:

Multisystem inflammatory syndrome in children is a rare, post-infectious complication of SARS-CoV-2 infection in children. We aimed to assess the long-term sequelae, particularly cardiac, in a large, diverse population.

Methods:

We performed a retrospective cohort study of all children (aged 0–20 years, n = 304) admitted to a tertiary care centre with a diagnosis of multisystem inflammatory syndrome in children from March 1, 2020 to August 31, 2021 and had at least one follow-up visit through December 31, 2021. Data were collected at hospitalisation, 2 weeks, 6 weeks, 3 months, and 1 year after diagnosis, where applicable. Cardiovascular outcomes included left ventricular ejection fraction, presence or absence of pericardial effusion, coronary artery abnormalities, and abnormal electrocardiogram findings.

Results:

Population was median age 9 years (IQR 5–12), 62.2% male, 61.8% African American (AA), and 15.8% Hispanic. Hospitalisation findings included abnormal echocardiogram 57.2%, mean worst recorded left ventricular ejection fraction 52.4% ± 12.4%, non-trivial pericardial effusion 13.4%, coronary artery abnormalities 10.6%, and abnormal ECG 19.6%. During follow-up, abnormal echocardiogram significantly decreased to 6.0% at 2 weeks and 4.7% at 6 weeks. Mean left ventricular ejection fraction significantly increased to 65.4% ± 5.6% at 2 weeks and stabilised. Pericardial effusion significantly decreased to 3.2% at 2 weeks and stabilised. Coronary artery abnormalities significantly decreased to 2.0% and abnormal electrocardiograms significantly decreased to 6.4% at 2 weeks and stabilised.

Conclusion:

Children with multisystem inflammatory syndrome in children have significant echocardiographic abnormalities during the acute presentation, but these findings typically improve within weeks. However, a small subset of patients may have persistent coronary abnormalities.

Keywords

MIS-Ccardiacoutcomes
Type
Original Article
Information
Cardiology in the Young , Volume 33 , Issue 12 , December 2023 , pp. 2632 - 2638
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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