Cardiac abnormalities due to multisystem inflammatory syndrome temporally associated with Covid-19 among children: A systematic review and meta-analysis

Abstract

Background: Cardiac defects due to multisystem inflammatory syndrome in children (MIS-C) have been abundantly reported leading high morbidity among children affected by Covid-19. We aimed to systematically assess the incidence of such cardiac abnormalities due to MIS-C in children suffering Covid-19.

Methods: The manuscript databases including Medline, Web of knowledge, Google scholar, Scopus, and Cochrane were deeply searched by the two blinded investigators for all eligible studies based on the relevant keywords. The risk of bias for each study was assessed according to QUADAS-2 tool. Statistical analysis was performed using the Comprehensive Meta Analysis (CMA) software.

Results: In final, 21 articles (including 916 children) were eligible for the final analysis that all yielded good quality and none of the citation was determined to have high risk of bias. Considering studies focusing different cardiac abnormalities related to MIS-C yielded a pooled prevalence of 38.0% for significant left ventricular dysfunction, 20.0% for coronary aneurism or dilatation, 28.1% for ECG abnormalities or cardiac arrhythmias, 33.3% for raised serum troponin level and 43.6% for raised proBNP/BNP level.

Conclusion: Although cardiac abnormalities among children suffering Covid-19 are uncommon, in the context of the MIS-C can be common and therefore potentially serious and life threatening.

Keywords: COVID-19; Cardiac abnormalities; Children; Multisystem inflammatory syndrome.

Fig. 1

The flowchart of screening the eligible studies.

Fig. 2

Assessment of the risk of bias.

Fig. 3

The pooled prevalence of RT-PCR positivity for Covid-19 genome.

Fig. 4a

The pooled prevalence of left ventricular dysfunction.

Fig. 4b

The pooled prevalence of coronary artery aneurism/dilatation.

Fig. 4c

The pooled prevalence of ECG abnormalities.

Fig. 4d

The pooled prevalence of raised serum troponin level.

Fig. 4e

The pooled prevalence of raised serum NT-ProBNP level.