Journal article
Evolution of Cardiovascular Findings in Multisystem Inflammatory Syndrome in Children (MIS-C) Across COVID-19 Variants: Common Trends and Unusual Presentations
Pediatric cardiology, Vol.45(3), pp.552-559
03/2024
DOI: 10.1007/s00246-023-03397-2
PMID: 38261062
Abstract
Multisystem inflammatory syndrome in children (MIS-C) is a rare condition following COVID-19 infection. Cardiac involvement is common and includes left ventricular systolic dysfunction, cardiac marker elevation, electrocardiogram (ECG) changes, and coronary artery dilation. This single-center retrospective cohort study compares cardiovascular disease between three major SARS-CoV-2 variants and describes the evolution of findings in medium-term follow-up. Of 69 total children (mean age 9.2 years, 58% male), 60 (87%) had cardiovascular involvement with the most common features being troponin elevation in 33 (47%) and left ventricular dysfunction in 22 (32%). Based on presumed infection timing, 61 patients were sorted into variant cohorts of Alpha, Delta, and Omicron. Hospitalization was longer for the Delta group (7.7 days) vs Alpha (5.1 days, p = 0.0065) and Omicron (4.9 days, p = 0.012). Troponin elevation was more common in Delta compared to Alpha (13/20 vs 7/25, p = 0.18), and cumulative evidence of cardiac injury (echocardiographic abnormality and/or troponin elevation) was more common in Delta (17/20) compared with Alpha (12/25, p = 0.013) or Omicron (8/16, p = 0.034). Forty-nine (77%) of the original cohort (n = 69) had no cardiac symptoms or findings beyond 3 months post-hospitalization. Cardiac MRI was performed in 28 patients (between 3 and 6 months post-hospitalization) and was normal in 25 patients (89%). The differences in the variant cohorts may be due to alteration of the immune landscape with higher severity of COVID-19 infection. Despite overall reassuring cardiac outcomes, it is important to note the variability of presentation and remain vigilant with future variants.
Details
- Title: Subtitle
- Evolution of Cardiovascular Findings in Multisystem Inflammatory Syndrome in Children (MIS-C) Across COVID-19 Variants: Common Trends and Unusual Presentations
- Creators
- Rabia S Khan - UCLA HealthTheadora Ordog - UC Irvine HealthSandy D Hong - University of IowaAnna H Schmitz - University of IowaBijoy Thattaliyath - University of IowaAnjali A Sharathkumar - University of Iowa
- Resource Type
- Journal article
- Publication Details
- Pediatric cardiology, Vol.45(3), pp.552-559
- DOI
- 10.1007/s00246-023-03397-2
- PMID
- 38261062
- ISSN
- 0172-0643
- eISSN
- 1432-1971
- Language
- English
- Electronic publication date
- 01/23/2024
- Date published
- 03/2024
- Academic Unit
- Cardiology; Stead Family Department of Pediatrics; Hematology/Oncology; Rheumatology, Allergy, and Immunology; Hospital Medicine
- Record Identifier
- 9984548466402771
Metrics
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