Key result
Children with MIS-C rapidly recover LVEF within a median of ~12 days.
Why the study?
Due to its link with SARS-CoV-2, MIS-C gained global attention as a serious condition requiring hospital care, prompting this assessment of patient characteristics by age group and ICU status alongside early echocardiographic changes.
What are the clinical, laboratory, and echocardiographic characteristics of MIS-C in children?
Cohort (n=42)
No
What are the clinical, laboratory, and echocardiographic characteristics of MIS-C in children?
p-value: p=<0.001
MIS-C presents with age-dependent symptoms and significant but rapidly resolving cardiovascular involvement, with specific inflammatory markers predicting disease severity.
May support short-term monitoring in MIS-C; leaves open long-term cardiac outcomes in prospective cohorts.
Background and Objectives: Due to its link with the SARS-CoV-2, Multisystem Inflammatory Syndrome in Children (MIS-C) gained global attention as a serious condition that requires hospital care. Our study aimed to present the clinical and laboratory characteristics of MIS-C patients by age group and intensive care unit (ICU) admission status and assess early echocardiographic changes. Materials and Methods: A single-center partly retrospective, partly prospective observational cohort study was performed from December 2020 to June 2024. The study included 42 patients aged between 1 month and 18 years who were diagnosed with MIS-C and gave informed consent. Results: The median age was 6.5 years (IQR 2.0–9.3). The predominant symptoms were cardiovascular (88.1%), mucocutaneous (85.7%) and gastrointestinal (76.2%). Five children (11.9%) developed shock. About two-thirds of patients (66.7%) were admitted to the ICU. Adolescents (≥12 years) were less likely to exhibit mucocutaneous or cardiovascular symptoms and thus less frequently having Kawasaki—like disease symptoms compared with other age groups (<5 years or 5–11 years). Lymphopenia was more common among patients aged 5 years and older. Adolescents had higher procalcitonin (PCT) and a lower estimated glomerular filtration rate. Troponin I and B-type natriuretic peptide (BNP) levels were higher in children aged 5–11 years, while ferritin levels were lower among the youngest (<5 years). Patients treated at the ICU were more likely to have cardiovascular and respiratory symptoms, as well as a history of symptomatic COVID-19, higher C-reactive protein (CRP), PCT, BNP and lower albumin levels. Echocardiographic abnormalities were found in 71.4% of cases. During hospitalization, left ventricular ejection fraction values increased significantly (p < 0.001) over 12 (IQR 9.0–14.0) days. Conclusions: Symptoms and laboratory markers of MIS-C vary according to age. Higher CRP, PCT, BNP and hypoalbuminemia are predictors of MIS-C severity. Cardiovascular involvement is common and might be severe, but rapid resolution is encouraging.
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Stacevičienė et al. (2024) conducted a cohort in Multisystem Inflammatory Syndrome in Children (MIS-C) (n=42). Multisystem Inflammatory Syndrome in Children (MIS-C) was evaluated on Change in left ventricular ejection fraction during hospitalization (p=<0.001). In children with MIS-C, left ventricular ejection fraction values increased significantly over a median of 12 days (p<0.001), with rapid resolution of cardiovascular abnormalities.
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