Cardiac affection in multisystem inflammatory syndrome in children: The Egyptian experience

Abstract

Background: Multisystem inflammatory syndrome in children (MIS-C) is an uncommon condition linked to SARS-CoV2, the virus responsible for COVID-19. Typically emerging 2-6 weeks after a child contracts the virus, MIS-C leads to inflammation in various organs, including the heart, kidneys, lungs, brain, skin, and gastrointestinal tract.
Objective: To assess the cardiac affection, management and outcome in MIS-C patients.
Patients and methods: This analytical cross-sectional study was carried out in Cairo University Children Hospital and included 28 patients, diagnosed with MIS-C post COVID. All patients were subjected to complete history taking, through general, cardiac examination and echocardiographic assessment.
Results: Males were the most commonly presented gender accounting for 71.4%, while females were 28.6%. Fever was the most commonly presented symptom (96.4%). Cardiac affection was found in 22 (78.6 %) patients by cardiac echocardiography and coronary dilatation was the most common finding by echocardiography in 18 (64.3%) patients. The most common was left coronary artery dilatation in 16 (57.1%) patients, followed by right coronary artery in 8 (28.6%) patients while only 2 (7.1%) had coronary artery aneurysm. All patients in the current study received intravenous immunoglobulin G (IVIG) for 2 days while 14 (50%) patients received pulse steroids followed by oral steroids after IVIG course.
Conclusion: Cardiac affection is common in MIS-C patients and must be looked for. The most common presentation is coronary artery dilatation; mostly left coronary artery so early and appropriate intervention is essential to avoid complications.