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. 2021 Jul 1;23(1):86.
doi: 10.1186/s12968-021-00786-5.

Cardiovascular magnetic resonance imaging in children after recovery from symptomatic COVID-19 or MIS-C: a prospective study

Gregory Webster  1 , Ami B Patel  2 , Michael R Carr  3 , Cynthia K Rigsby  4   5 , Karen Rychlik  6 , Anne H Rowley  2 , Joshua D Robinson  3   4
Affiliations

Cardiovascular magnetic resonance imaging in children after recovery from symptomatic COVID-19 or MIS-C: a prospective study

Gregory Webster et al. J Cardiovasc Magn Reson. .

Abstract

Background: Cardiac evaluations, including cardiovascular magnetic resonance (CMR) imaging and biomarker results, are needed in children during mid-term recovery after infection with SARS-CoV-2. The incidence of CMR abnormalities 1-3 months after recovery is over 50% in older adults and has ranged between 1 and 15% in college athletes. Abnormal cardiac biomarkers are common in adults, even during recovery.

Methods: We performed CMR imaging in a prospectively-recruited pediatric cohort recovered from COVID-19 and multisystem inflammatory syndrome in children (MIS-C). We obtained CMR data and serum biomarkers. We compared these results to age-matched control patients, imaged prior to the SARS-CoV-2 pandemic.

Results: CMR was performed in 17 children (13.9 years, all ≤ 18 years) and 29 age-matched control patients without SARS-CoV-2 infection. Cases were recruited with symptomatic COVID-19 (11/17, 65%) or MIS-C (6/17, 35%) and studied an average of 2 months after diagnosis. All COVID-19 patients had been symptomatic with fever (73%), vomiting/diarrhea (64%), or breathing difficulty (55%) during infection. Left ventricular and right ventricular ejection fractions were indistinguishable between cases and controls (p = 0.66 and 0.70, respectively). Mean native global T1, global T2 values and segmental T2 maximum values were also not statistically different from control patients (p ≥ 0.06 for each). NT-proBNP and troponin levels were normal in all children.

Conclusions: Children prospectively recruited following SARS-CoV-2 infection had normal CMR and cardiac biomarker evaluations during mid-term recovery. Trial Registration Not applicable.

Keywords: COVID-19; Cardiac magnetic resonance imaging; MIS-C; Pediatric; SARS-CoV-2.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Parent report of prevalence of symptoms among cases. The ordinate axis displays the frequency of each symptom by parent report in participants with COVID-19 (n = 11) or MIS-C (n = 6). Parents were permitted to endorse all relevant symptoms and so the numbers do not equal the number of participants
Fig. 2
Fig. 2
No CMR Abnormalities Were Present Following SARS-CoV-2 Infection in Children. Violin plots comparing CMR indices in cases and controls, with scatterplots overlaid. There was no difference between mean values in symptomatic COVID-19/MIS-C patients and control patients by A native global T1, B native global T2, or C segmental maximum T2 myocardial mapping. Blue circles = symptomatic COVID-19; red diamonds = MIS-C; tan squares = control patients; ms = milliseconds. Dashed horizontal line = median; dotted horizontal lines = quartiles
See this image and copyright information in PMC

References

    1. Castagnoli R, Votto M, Licari A, Brambilla I, Bruno R, Perlini S, et al. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children and adolescents: a systematic review. JAMA Pediatr. 2020;174(9):882–889. doi: 10.1001/jamapediatrics.2020.1467. - DOI - PubMed
    1. Ng MY, Ferreira VM, Leung ST, Yin Lee JC, Ho-Tung Fong A, To Liu RW, et al. Patients recovered from COVID-19 show ongoing subclinical myocarditis as revealed by cardiac magnetic resonance imaging. JACC Cardiovasc Imaging. 2020;13(11):2476–2478. doi: 10.1016/j.jcmg.2020.08.012. - DOI - PMC - PubMed
    1. Puntmann VO, Carerj ML, Wieters I, Fahim M, Arendt C, Hoffmann J, et al. Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from coronavirus disease 2019 (COVID-19) JAMA Cardiol. 2020;5(11):1265–1273. doi: 10.1001/jamacardio.2020.3557. - DOI - PMC - PubMed
    1. Rajpal S, Tong MS, Borchers J, Zareba KM, Obarski TP, Simonetti OP, et al. Cardiovascular magnetic resonance findings in competitive athletes recovering from COVID-19 infection. JAMA Cardiol. 2021;6(1):116–118. - PMC - PubMed
    1. Starekova J, Bluemke DA, Bradham WS, Eckhardt LL, Grist TM, Kusmirek JE, et al. Evaluation for myocarditis in competitive student athletes recovering from coronavirus disease 2019 with cardiac magnetic resonance imaging. JAMA Cardiol. 2021. - PMC - PubMed

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Supplementary concepts