Search for clinico-biological and echographic correlations of cardiac involvement in MIS-C

Abstract

IntroductionWhile children seemed spared by the pandemic due to SARS-CoV-2, a new clinical entity was described in the spring of 2020 in connection with this infection and called Multisystem Inflammatory Syndrome in Children (MIS-C). Cardiac involvement is frequent but most often transient; it is sought in any child with MIS-C.ObjectiveThis study aims to search for clinical and biological elements associated with cardiac involvement on echocardiography in the MIS-C.MethodsThis is a descriptive and analytical prospective study of MIS-C cases related to COVID-19 treated in the pediatric department of the Annaba University Hospital from April 14, 2020, and April 14, 2022.ResultsWe included 65 patients hospitalized for MIS-C. The average age was 7 years old. All the children had a disturbance of the inflammatory markers, 25 had an elevated Pro BNP level, and 24 had a high troponin level. Forty-two percent of the children presented an objectified cardiac involvement on echocardiography. These were mainly signs of myocarditis and coronary dilatation. Only one patient had a coronary aneurysm. We deplore three deaths in our series. Comparing the clinical and biological profiles of patients with and without cardiac involvement objectified on ultrasound does not find any age difference between the two groups. Typical or atypical shocks were the most common clinical form in cases of cardiac involvement. Analysis of the biological assessment found significantly (P < 0.05) higher levels of troponin and Pro BNP in the event of cardiac involvement in MIS-C.ConclusionCardiac dysfunction during MIS-C is usually resolved with treatment combining immunoglobulins and corticosteroids. Today, new physiopathological leads allow a better understanding of the pathogenesis of this cardiac manifestation.