Acute Cardiovascular Manifestations in Patients with Multisystem Inflammatory Syndrome Associated to Sars-Cov-2 Infection

ABSTRACT

BACKGROUND AND AIM: To describe the cardiovascular and laboratory manifestations among children presenting with the multisystem inflammatory syndrome associated with SARS-CoV-2 infection (MIS-C). METHOD(S) Data obtained from the database of our PICU complemented by a review of the clinical records. Children from 1 month to 15 years of age, admitted to the hospital between August 1, 2020 and December 31, 2021 with a diagnosis of MIS-C were included. RESULT(S) A total of 8 children, represent 6% of our admissions during the study period, were included. Median age 5.7 years (IQR 1.5-10), 100% males, weight 10 to 59 kg, PICU LOS 1 to 11 days, median 2.6 days (IQR 1-7.5). PIM-3 median 1.75 (IQR 1.17- 2.54). Symptoms were persistent fever, gastrointestinal symptoms, polymorphic rash, conjunctivitis, and mucosal changes.The cardiovascular complications were shock, cardiac arrhythmias, pericardial effusion and coronary artery dilatation. Reduced left ventricular ejection fraction and elevated troponin were present in half of them. The biochemical markers of inflammation were raised in most patients elevated C-reactive protein, serum ferritin, procalcitonin, N-terminal pro B-type natriuretic peptide, interleukin-6 level, and D-dimers. Polymerase chain reaction for SARS-CoV-2 virus was negative in all patients, whereas immunoglobulin (Ig) M antibodies were positive in 50% and IgG in 87.5% cases. CONCLUSION(S) The children have significantly raised levels of biochemical markers of inflammation.Cardiac involvement, including ventricular dysfunction, coronary artery dilation or aneurysm, and arrhythmias, is common in children with SARS-CoV-2-associated multisystem inflammatory syndrome and needs to be carefully identified and monitored over time due to uncertain prognosis and risk of progression of cardiac manifestation. (Figure Presented).