This study did not require approval from the Ethics Committee. The data that support the findings of this study are available from the corresponding author, upon reasonable request. Longitudinal follow-up showed improvement in all of these findings, with resolution of most by early follow-up. The TTE findings in patients with MIS-C are striking and fit a clear pattern of systemic inflammation and pancarditis that includes holodiastolic reversal of flow in the descending aorta, LV systolic dysfunction, LV diastolic dysfunction, CA abnormalities, valvar dysfunction, and pericardial effusion. This is the first report to describe all of the abnormal features of the TTE during the acute phase of MIS-C, with the findings suggestive of a pancarditis, arteritis, and systemic inflammatory response similar to that seen in KD.
The TTE findings in patients with MIS-C are striking and fit a pattern that includes holodiastolic reversal of flow in the descending aorta, LV systolic dysfunction, LV diastolic dysfunction, CA abnormalities, valvar dysfunction, and pericardial effusion. Twenty six percent were Hispanic, and the racial breakdown was as follows: 42% multiracial, 30% Black, 8% White, 12% Discussion The mean age was 8.3 years (range 9 months to 17 years). Data collectionįifty patients were admitted to our hospital between Maand Jand met the CDC criteria for MIS-C 45 patients (90%) were positive for serum SARS-CoV-2 IgG antibodies, 13 patients (26%) were positive by nasopharyngeal PCR, and 8 (16%) patients were positive for both. Patients in this study were also included in publications from other investigators from our institution. This is a retrospective single center study that includes consecutive pediatric patients age ≤ 18 years who were admitted to Cohen Children's Medical Center (Northwell Health) from Mato Jwith laboratory-confirmed SARS-CoV-2 infection by respiratory polymerase chain reaction (PCR) testing and/or IgG serology and met CDC criteria for MIS-C.
#TRIVIAL PERICARDIAL EFFUSION SERIAL#
We sought to comprehensively describe the findings on TTE during the acute phase of MIS-C in one of the largest single-center cohorts of pediatric patients, and how those findings improve on serial longitudinal follow-up 6 months from initial diagnosis.
Few reports have noted the incidence of valvar regurgitation and/or pericardial effusion, with one study of 12 patients reporting small effusions in 33%, mild or greater mitral regurgitation (MR) in 25%, and mild or greater tricuspid regurgitation (TR) in 17%. While CA dilation and LV dysfunction are extremely important, they do not comprise the entirety of the cardiac involvement that can be seen with transthoracic echocardiography (TTE). CA aneurysms range in incidence from 14 to 24% and LV systolic dysfunction has been reported in 31% to 58%. There have been multiple reports on coronary artery (CA) dilation and left ventricular (LV) systolic dysfunction in MIS-C. Multisystem inflammatory syndrome in children (MIS-C) has been described as a post-inflammatory condition associated with Coronavirus Disease 2019 (COVID-19) with a range of clinical features, including cardiac manifestations similar to Kawasaki disease (KD), ,.
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