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Review
. 2021 Dec:63:101365.
doi: 10.1016/j.ppedcard.2021.101365. Epub 2021 Feb 9.

Cardiac manifestations, treatment characteristics, and outcomes of paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus-2: A systematic review

Joshua Henrina  1 , Iwan Cahyo Santosa Putra  1 , Sherly Lawrensia  2 , Della Sabrina Marta  2 , Ellen Wijaya  3 , Aninka Saboe  4 , Charlotte Johanna Cool  4 , Leonardo Paskah Suciadi  5
Affiliations
Review

Cardiac manifestations, treatment characteristics, and outcomes of paediatric inflammatory multisystem syndrome temporally associated with severe acute respiratory syndrome coronavirus-2: A systematic review

Joshua Henrina et al. Prog Pediatr Cardiol. 2021 Dec.

Abstract

Background: Paediatric inflammatory multisystem syndrome (PIMS) temporally associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) (PIMS-TS) is a rare clinical syndrome associated with a multiorgan system dysfunction, especially acute cardiac injury, and mandates a higher level of care.

Aim of review: To investigate cardiac manifestations, treatment characteristics, and outcomes of PIMS-TS.

Key scientific concepts of review: Twenty-six studies were included with 1228 pooled subjects, with a mean age of 8.6 years, which were dominated by male gender (53%), and African ethnicity (31%). 732 (38%) patients were reactive on a serological test, and 457 patients (45%) were positive on SARS-CoV-2 RT-PCR. ST-segment abnormalities were the most common ECG findings (16%, n/N: 34/212). Various markers of troponin and the pooled mean of BNP and NT-pro-BNP levels were elevated. Cardiomegaly and pericardial effusion (21.8%, n/N: 164/751) were the most common chest X-ray findings. In echocardiography, the majority of patients' left ventricular ejection fraction was reduced (59.0%, n/N: 180/305), with pericardial effusion/ pericarditis seen the most (17.44%, n/N: 221/1267), and Z score ≥ 2 in 28% (n/N: 42/139). Cardiac MRI findings were consistent with acute myocarditis. Intravenous immunoglobulin, corticosteroids, and vasoactive drugs were frequently utilized. The mean length of stay was 6 days, with most patients (71%, n/N: 834/1163) were admitted to the ICU. However, the overall prognosis was favorable, with 98% alive (n/N: 1235/1260), and more than 50% of patients experienced recovery of left ventricular systolic functions at discharge (116 out of 206 patients).

Keywords: COVID-19; Kawasaki; PIMS-TS; SARS-CoV-2; Toxic shock syndrome.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Study profile.
Fig. 2
Fig. 2
Mechanistic underpinnings of Pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2.
See this image and copyright information in PMC

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