ABSTRACT
Purpose of Study Objective: To evaluate the short and midterm cardiac outcomes in children hospitalized with MIS-C in two pediatric intensive care units (PICU) in New Jersey. Methods Used Design/Methods: We conducted a retrospective review of children admitted to the PICU with a diagnosis of MIS-C between April 2020 through March 2021. Cardiac biomarkers and echocardiograms performed during hospitalization were analyzed. Follow-up echocardiograms were performed two to eight weeks post-discharge, with interval follow-up of up to one year. Shortening fraction (SF) was used to assess left ventricular systolic function using standard M-mode (SF < 28% considered abnormal). Summary of Results Results: Twenty-seven patients (18 male;median age 11 years) were included. The mean peak Troponin I in 25 patients was 2.10 +/- 5.0 ng/dL, and mean peak NTProBNP level in 26 patients was 1,606 +/- 1293 pg/dL. Most patients had normalization of cardiac biomarkers by time of discharge (table 1). Seven of the 23 patients who had an echocardiogram on admission had a SF less than 28%. Lowest SF and SF at the time of discharge were compared in 21 patients with a median improvement of 6% (p <0.001) (table 2). Nineteen patients had a follow-up echocardiogram two to ten weeks post discharge and 18 of those had normal left ventricular systolic function (p < 0.001). No patient had evidence of diastolic dysfunction at follow-up. Eight patients had midterm follow-up five to seven months post-discharge;one patient was followed for one-year post-discharge. Abnormalities that persist in these patients include low normal left ventricular systolic function. Three subjects had evidence of left coronary artery dilation (z score >2) during hospitalization and continued to have diffuse dilation at follow up, with one developing right coronary artery dilation. Conclusions Conclusion: In this cohort of patients, most children admitted to the PICU with MIS-C had abnormal cardiac biomarkers with normal to mildly decreased left ventricular systolic function that improved by time of discharge and continued to improve with midterm (5-7 months) follow-up. A very small subset of patients, however, continue to have cardiac complications including diffuse coronary artery dilation. (Table Presented).