In:
Frontiers in Pediatrics, Frontiers Media SA, Vol. 10 ( 2022-3-2)
Abstract:
Heart involvement in multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) is a new challenging problem, requiring fast and reliable diagnostics and appropriate treatment. The aim of this study is to describe heart involvement in patients with MIS-C. Study Design In this retrospective, multicenter cohort study, data of 122 patients were included. All patients met WHO and CDC criteria of MIS-C. Results Various types of heart involvement in MIS-C patients were observed. Patients with solely coronary artery lesions (CAL, n = 10, 8.2%) had typical features of Kawasaki disease: younger age, thrombocytosis and normal ferritin level, without giant CA aneurysms, thrombosis, myocardial infarction, shock, and ICU admission. Patients with solely myocardial involvement (MI, n = 30, 24.6%) had an older onset age, elevated ferritin, LDH, the highest D-dimer, H score, and thrombocytopenia level. The following clinical signs were associated with MI: gastrointestinal and central nervous system disorder, sore throat, swelling face, splenomegaly, shock, and treatment in the intensive care unit required. Patients with a combination of CAL and MI ( n = 10, 8.2%) had symptoms similar to patients with solely MI, except for impressive thrombocytopenia. Shock and ICU admission were found in 34.7% of patients without heart involvement ( n = 72, 59%). One major criterion [troponin & gt; 32 pg/ml (52 points)] or at least two minor criteria [face swelling (32 points) and D-Dimer & gt; 1,300 ng/ml (29 points)] were associated with MI ( & gt;32 points) with a sensitivity of 67.5% and a specificity of 88.9%. Conclusion The above-suggested criteria can be added to routine diagnostic procedures to confirm MI in MIS-C patients.
Type of Medium:
Online Resource
ISSN:
2296-2360
DOI:
10.3389/fped.2022.829420
Language:
Unknown
Publisher:
Frontiers Media SA
Publication Date:
2022
detail.hit.zdb_id:
2711999-3
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