33: LONG-TERM CARDIAC AND FUNCTIONAL OUTCOMES OF MULTISYSTEM INFLAMMATORY SYNDROME IN CHILDREN

Abstract

Introduction: Multi-system Inflammatory Syndrome (MIS-C) is a hyperinflammatory state involving two or more organs associated with a previous diagnosis of SARS-CoV-2. Cardiac dysfunction is described in 80-85% of cases. Currently, there is a knowledge gap regarding long-term cardiac and functional outcomes in children diagnosed with MIS-C. Methods: We conducted a retrospective chart review of children < 21 years admitted to our hospital for MIS-C between January 2020 and January 2022. We collected demographic, clinical, laboratory, imaging data [left ventricular ejection fraction (LVEF), coronary artery dilation (CAD)], and functional status score (FSS) during hospital stay and long-term (up to 6 months) follow up. Using a student t-test and chi-square test, we compared the outcomes of children admitted to the pediatric intensive care unit (PICU) vs outside the PICU. Results: Out of the 40 children admitted to the hospital with MIS-C during the study period, 16 (40%) were admitted to the PICU while 24 (60%) were admitted outside the PICU. Of the PICU patients, 13.33% showed CAD and 31.25% had a LVEF ≤55% on at least one echocardiogram during their hospital stay. Of the echocardiograms completed on the non-PICU patients (n=22), 18.18% showed CAD and 9.09% had a LVEF ≤55% on at least one echo during admission. Between PICU and non-PICU patients, there was a significant (p ≤ 0.05) difference in mean length of stay (13.56 vs. 6.16 days respectively), lowest LVEF (56.14% vs 62.58%), and change in Functional Status Score (ΔFSS) (0.5 vs 0.0). Of the 16 PICU patients, 11 had follow-up echocardiogram and none had persistent CAD and/or LVEF ≤55%. Of the 20/24 (83.33%) non-PICU patients with echocardiograms at follow-up, 10% displayed persistent coronary artery dilation while none had LVEF ≤55%. At follow-up, a significant proportion of non-PICU patients had persistent CAD as compared to PICU patients (p≤0.0001), but there was no difference in LVEF and ΔFSS amongst the two cohorts. Conclusions: A significant proportion of children admitted outside the PICU had persistent coronary abnormalities at up to 6 month follow up compared to patients admitted in the PICU. However, none of the patients had persistent low LVEF (≤55%) or functional disability at up to 6 month follow up (ΔFSS).