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. 2022 Apr 20;9(5):583.
doi: 10.3390/children9050583.

Cardiovascular Manifestations in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19 According to Age

Claudia Campanello  1 , Claudia Mercuri  2 , Maria Derchi  3 , Gianluca Trocchio  3 , Alessandro Consolaro  2   4 , Roberta Caorsi  4 , Angelo Ravelli  2   5 , Alessandro Rimini  3 , Maurizio Marasini  3 , Marco Gattorno  2   4
Affiliations

Cardiovascular Manifestations in Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with COVID-19 According to Age

Claudia Campanello et al. Children (Basel). .

Abstract

Cardiac involvement in multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus-19 disease is often observed with a high risk of heart failure. The aim is to describe cardiovascular involvement, management and early outcome in MIS-C by comparing cardiovascular manifestations in children younger and older than 6 years old. This retrospective observational study included 25 children with MIS-C, admitted to a single pediatric center between March 2020 and September 2021. The median age was 5 years (13 patients under 6 years and 12 over 6 years); coronary artery abnormalities were observed in 77% of preschoolers, with small and medium aneurysms in half of the cases and two cases of mild ventricular dysfunction. School-age children presented myopericardial involvement with mild to moderate ventricular dysfunction in 67% of cases, and two cases of transient coronary dilatation. There was a significant NT-pro-BNP and inflammatory markers increase in 25 of the patients, and mild elevation of troponin I in 9. All patients were treated with intravenous immunoglobulin and corticosteroids, and 8 with anakinra. None of the patients needed inotropes or intensive care unit admission. Our study shows the frequent cardiovascular involvement in MIS-C with a peculiar distribution, according to different age group: coronary artery anomalies were more frequent in the younger group, and myopericardial disease in the older one. A prompt multitarget, anti-inflammatory therapy could probably contribute to a favorable outcome.

Keywords: COVID-19; cardiovascular manifestations; multisystem inflammatory syndrome in children; pediatrics.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Laboratory findings: lymphocytes ratio and ferritin. (a) Lymphocytes ratio between the total lymphocytes and the lower normal limit for age was statistically significantly lower in group 2 (≥6 years) than in group 1 (<6 years); (b) Ferritin statistically significantly higher in group 2 (≥6 years) than in group 1 (<6 years). Yrs old: years old.
Figure 2
Figure 2
(a) Fibrinogen levels significantly higher in reduced LVEF group. (b) Trend of LVEF, according to NT-pro-BNP levels. LVEF: left ventricular ejection fraction; IQR: interquartile range; NT-pro-BNP: N-terminal prohormone of brain natriuretic peptide.
See this image and copyright information in PMC

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