Acute cardiovascular manifestations with multisystem inflammatory syndrome in children due to COVID-19 infection: A single-center prospective observational study

Abstract

Abstract Background: Cardiac involvement is common in children with multisystem inflammatory syndrome associated with the COVID-19 pandemic. A majority of children have significantly raised levels of NT pro-BNP, ferritin, D-dimers, and cardiac troponin in addition to high C-reactive protein and procalcitonin levels. Cardiac involvement may include rhythm disturbance, depressed myocardial function, valvar regurgitation, and/or coronary artery inflammation. This hospital-based prospective study was aimed to evaluate cardiovascular manifestations in cases of multisystem inflammatory syndrome in children (MIS-C). Subjects and Methods: The current study was a prospective observational study that included 100 children admitted to the pediatric intensive care unit after getting the requisite clearance from the institutional ethics committee; informed written consent of parents was taken before the start of the study. Results: The mean age of the study participants was 8.9 ± 3.9 years with 62% male children. Ninety-four percentage had MIS-C with KD phenotype while only 6% of kids developed shock. Abnormal electrocardiography (ECG) was found in 41%, pericardial effusion in 16%, left ventricular dysfunction (LVD) in 42%, and coronary lesions found in 30% of patients. Abnormal NT-proBNP (>125 pg/ml) was noted in 90% of children. Abnormal cTnT was seen in 89%, and 91% of children had abnormal BNP. The present study found a mortality of 6%. Conclusions: MIS-C with KD phenotype is the most common presentation with raised cardiac injury markers. Abnormal ECG LVD and coronary lesions are transient common cardiac abnormalities which get resolved within 3 months of treatment.