1. Echocardiographic Findings in Pediatric Multisystem Inflammatory Syndrome Associated With COVID-19 in the United States.
- Author
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Matsubara, Daisuke, Kauffman, Hunter L., Wang, Yan, Calderon-Anyosa, Renzo, Nadaraj, Sumekala, Elias, Matthew D., White, Travus J., Torowicz, Deborah L., Yubbu, Putri, Giglia, Therese M., Hogarty, Alexa N., Rossano, Joseph W., Quartermain, Michael D., and Banerjee, Anirban
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MUCOCUTANEOUS lymph node syndrome , *COVID-19 , *CORONARY arteries , *SYNDROMES , *VIRAL pneumonia , *ECHOCARDIOGRAPHY , *HEART , *SYSTEMIC inflammatory response syndrome , *RETROSPECTIVE studies , *EPIDEMICS , *DISEASE complications - Abstract
Background: Centers from Europe and United States have reported an exceedingly high number of children with a severe inflammatory syndrome in the setting of coronavirus disease 2019, which has been termed multisystem inflammatory syndrome in children (MIS-C).Objectives: This study aimed to analyze echocardiographic manifestations in MIS-C.Methods: A total of 28 MIS-C, 20 healthy control subjects and 20 classic Kawasaki disease (KD) patients were retrospectively reviewed. The study reviewed echocardiographic parameters in the acute phase of the MIS-C and KD groups, and during the subacute period in the MIS-C group (interval 5.2 ± 3 days).Results: Only 1 case in the MIS-C group (4%) manifested coronary artery dilatation (z score = 3.15) in the acute phase, showing resolution during early follow-up. Left ventricular (LV) systolic and diastolic function measured by deformation parameters were worse in patients with MIS-C compared with KD. Moreover, MIS-C patients with myocardial injury were more affected than those without myocardial injury with respect to all functional parameters. The strongest parameters to predict myocardial injury in MIS-C were global longitudinal strain, global circumferential strain, peak left atrial strain, and peak longitudinal strain of right ventricular free wall (odds ratios: 1.45 [95% confidence interval (CI): 1.08 to 1.95], 1.39 [95% CI: 1.04 to 1.88], 0.84 [95% CI: 0.73 to 0.96], and 1.59 [95% CI: 1.09 to 2.34], respectively). The preserved LV ejection fraction (EF) group in MIS-C showed diastolic dysfunction. During the subacute period, LVEF returned to normal (median from 54% to 64%; p < 0.001) but diastolic dysfunction persisted.Conclusions: Unlike classic KD, coronary arteries may be spared in early MIS-C; however, myocardial injury is common. Even preserved EF patients showed subtle changes in myocardial deformation, suggesting subclinical myocardial injury. During an abbreviated follow-up, there was good recovery of systolic function but persistence of diastolic dysfunction and no coronary aneurysms. [ABSTRACT FROM AUTHOR]- Published
- 2020
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