Infectious Disease

Cardiac Function Recovery Rapid in COVID-19-Related MIS-C; coronary results good

January 19, 2022

2 minutes read

Source/Disclosures

Published by:

Cardiology today logo

Disclosure:
The authors report no relevant financial information.

ADD TOPIC TO EMAIL ALERTS

Receive an email when new articles are published

Please enter your email address to receive an email when new articles are published . ” data-action=”subscribe”> Subscribe

We could not process your request. Please try again later. If this issue persists, please contact customerservice@slackinc.com.

Back to Healio

Most pediatric patients with multisystem inflammatory syndrome also had evidence of myocardial injury, but functional recovery occurred quickly and without adverse coronary sequelae, the researchers reported.

According to data published in the Journal of the American Heart Association, cardiac deformity markers improved rapidly within the first week and showed continuous improvement during 3 to 4 months of follow-up.

Source: Adobe Stock

Source: Adobe Stock

COVID-19 related MIS-C

“Children’s multisystem inflammatory syndrome (MIS-C) is a newly described hyperinflammatory syndrome associated with prior exposure to COVID-19. Cardiovascular involvement is common (80% to 85% of cases), including shock, left ventricular dysfunction, coronary artery abnormalities, and biochemical evidence of myocardial injury.” Daisuke Matsubara, MD, PhD, cardiologist at Children’s Hospital of Philadelphia, and colleagues wrote. “The aim of this study is to describe cardiac outcomes during a 3-month follow-up period to determine the short-term effects of MIS-C-induced acute myocardial injury.”

According to the CDC, MIS-C is a condition in which organs and systems such as the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs can become inflamed.

This analysis included 60 control subjects (mean age 12 years; 55% boys; 62% whites) and 60 patients with MIS-C (mean age 10 years; 60% boys; 27% whites), with echocardiograms and deformation parameters analyzed during the acute phase of the COVID-19 infection, the subacute phase (3 days after initial echocardiography), at 1 month (median 22 days), and at 3 to 4 months.

Recovery of cardiac function in MIS-C

Researchers defined myocardial damage during the acute phase as troponin I levels of 0.09 ng/mL or greater or brain-type natriuretic peptide greater than 800 pg/mL.

According to the researchers, 70% of patients with MIS-C had evidence of myocardial damage at the time of presentation; However, most cardiac markers normalized by the subacute stage prior to hospital discharge. The investigators reported no deaths or unexpected cardiac events during follow-up.

All deformity parameters, including LV global longitudinal strain, peak left atrial strain, early-diastolic longitudinal strain rate, and right ventricular free wall strain, recovered rapidly within the first week and improved and normalized in patients with MIS-C at 3 months of follow-up , according to the study.

Normalization of both global longitudinal load and left atrial load in patients with MIS-C occurred between 3 and 9 days, Matsubara and colleagues wrote.

The researchers reported that 7% of participants with MIS-C had small coronary aneurysms at presentation, all of which resolved.

Nine patients underwent cardiac MRI during follow-up (median 162 days), one of whom the researchers said had residual edema but no fibrosis.

“The recovery of these children has been excellent,” Anirban Banerjee, MD, professor of clinical pediatrics at the University of Pennsylvania Perelman School of Medicine and treating cardiologist at the Cardiac Center at Children’s Hospital of Philadelphia, said in a press release. “These findings have important implications for our healthcare teams managing care for children with MIS-C. Our results may also provide evidence for a gradual return to exercise after cardiac clearance 3 to 4 months later. Tests required for clearance include an electrocardiogram and an echocardiogram. We also recommend cardiac MRI for children who have a grossly abnormal cardiac MRI baseline during the acute stage or who show signs of ongoing severe left ventricular dysfunction.”

References:

ADD TOPIC TO EMAIL ALERTS

Receive an email when new articles are published

Please enter your email address to receive an email when new articles are published . ” data-action=”subscribe”> Subscribe

We could not process your request. Please try again later. If this issue persists, please contact customerservice@slackinc.com.

Back to Healio

COVID-19 Resource Center

COVID-19 Resource Center

Related Articles