Cardiac manifestations in children and adolescents diagnosed with pediatric multisystem inflammatory syndrome related to COVID-19

IF 3 4区医学 Q1 PEDIATRICS

Jornal de pediatria Pub Date : 2025-11-01 Epub Date: 2025-10-31 DOI:10.1016/j.jped.2025.101461

Thiago T. Panizzi , Katharine A. de Souza , Gabriela B. Stutz , Fernanda M.C.F. Lemos , Marta C.F. Rodrigues , Rozana G. de Almeida , Luciane A. da Rocha , Flavio R. Sztajnbok , Adriana R. Fonseca , Nathalie J.M. Bravo-Valenzuela

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引用次数: 0

Abstract

Objectives

To describe clinical and cardiologic findings in patients with multisystem inflammatory syndrome in children (MIS-C) in a follow-up of up to 3 years.

Materials and methods

A retrospective-prospective, observational, longitudinal study was conducted, including children and adolescents up to 18 years diagnosed with MIS-C (WHO criteria), at a university center between March 2020 and December 2024. Demographic, clinical, and laboratory data, electrocardiograms, and transthoracic echocardiograms were analyzed at admission and at 12 months and left ventricular global longitudinal strain (LV-GLS) three years after diagnosis. Statistical analysis used frequencies for categorical variables, and means with standard deviations or medians with interquartile ranges for continuous variables. Differences in proportions between patients with and without cardiovascular abnormalities were assessed using Fisher's exact test, Chi-squared, or Wilcoxon rank-sum test (significant p-value < 0.05). T-test was used to compare left ventricular ejection fraction (LVEF) and coronary artery Z scores.

Results

Thirty-six patients were included (males 69.4%), with a median age at diagnosis of 2.15 years (IQR 3.3). At admission, 41.7% presented with clinical or echocardiographic abnormalities, which were absent at 1-year follow-up. However, three years after diagnosis, among the 11 patients evaluated with LV-GLS, 10 showed changes indicating subclinical dysfunction not detected by conventional electrocardiogram or echocardiography.

Conclusion

Clinical and echocardiographic cardiovascular abnormalities are common in the acute phase of MIS-C. Although most patients showed clinical and echocardiographic resolution, LV-GLS proved valuable for detecting subclinical myocardial dysfunction not identified by conventional evaluation, highlighting its potential as a screening tool in short- and long-term follow-up.

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与COVID-19相关的小儿多系统炎症综合征患儿和青少年的心脏表现

目的：在长达3年的随访中描述儿童多系统炎症综合征（MIS-C）患者的临床和心脏病学表现。材料和方法：在2020年3月至2024年12月期间，在一所大学中心进行了一项回顾性、前瞻性、观察性、纵向研究，研究对象包括被诊断为misc（世卫组织标准）的18岁以下儿童和青少年。分析入院时、12个月时的人口统计学、临床和实验室数据、心电图和经胸超声心动图，以及诊断后3年的左心室整体纵向应变（LV-GLS）。统计分析对分类变量使用频率，对连续变量使用标准差平均值或四分位数区间中位数。采用Fisher精确检验、卡方检验或Wilcoxon秩和检验评估有和无心血管异常患者比例的差异（p值< 0.05）。采用t检验比较左室射血分数（LVEF）与冠状动脉Z评分。结果：纳入36例患者（男性69.4%），诊断时中位年龄2.15岁（IQR 3.3）。入院时，41.7%的患者表现为临床或超声心动图异常，1年随访时未见异常。然而，在诊断3年后，在11例进行LV-GLS评估的患者中，有10例出现了常规心电图或超声心动图未检测到的亚临床功能障碍的变化。结论：临床和超声心动图上的心血管异常在MIS-C急性期是常见的。尽管大多数患者表现出临床和超声心动图分辨率，但LV-GLS在检测常规评估无法识别的亚临床心肌功能障碍方面证明了其价值，突出了其作为短期和长期随访筛查工具的潜力。

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来源期刊

Jornal de pediatria 医学-小儿科

CiteScore

5.60

自引率

3.00%

发文量

审稿时长

43 days

期刊介绍： Jornal de Pediatria is a bimonthly publication of the Brazilian Society of Pediatrics (Sociedade Brasileira de Pediatria, SBP). It has been published without interruption since 1934. Jornal de Pediatria publishes original articles and review articles covering various areas in the field of pediatrics. By publishing relevant scientific contributions, Jornal de Pediatria aims at improving the standards of pediatrics and of the healthcare provided for children and adolescents in general, as well to foster debate about health.