Cardiac Manifestations in Multi-System Inflammatory Syndrome in Children Temporally Associated with SARS-CoV-2 Infection

Abstract

Objectives: The objective of this study was to assess the cardiac manifestations due to MIS-C by echocardiogram and to analyze the outcome and follow-up changes at 2 weeks and 6 weeks. Material and Methods: This prospective descriptive study was conducted in a tertiary care center in Coimbatore, Tamil Nadu, for 1 year. The study population included patients diagnosed with MIS-C. Cardiac manifestations were assessed clinically by echocardiogram findings, z-score calculation, and cardiac biochemical markers which were collected during hospital stay and at subsequent review and analyzed. Results: A total of 34 MIS-C patients were included in this study, with a median age of 6.5 years. Among the 15 patients with electrocardiogram (ECG) data, 8 (53%) had abnormal ECG findings. Most common findings are sinus tachycardia, sinus bradycardia, and non-specific T wave changes. An abnormal echocardiogram was noted in 27 out of 34 children. Coronary abnormalities were noted in 12 patients, of which seven had coronary dilation, and seven had a coronary aneurysm. Follow-up data were available for 20 patients. Two weeks after discharge, one patient had a persistent coronary aneurysm that resolved at 6 weeks follow-up. All other abnormalities were resolved at 2 weeks follow-up. Conclusion: Cardiac involvement is common in MIS-C, as 27 out of 34 children have manifested the same in our study population. These patients with appropriate early management had an excellent short-term outcome with complete resolution of echocardiogram findings.