Author/Authors :
Vukomanovic, Vladislav Department of Cardiology - Mother and Child Health Institute of Serbia, Belgrade, Serbia , Krasic, Stasa Department of Cardiology - Mother and Child Health Institute of Serbia, Belgrade, Serbia , Prijic, Sergej Department of Cardiology - Mother and Child Health Institute of Serbia, Belgrade, Serbia , Petrovic, Gordana Department of Immunology - Mother and Child Health Institute of Serbia, Belgrade, Serbia , Ninic, Sanja Department of Cardiology - Mother and Child Health Institute of Serbia, Belgrade, Serbia , Popovic, Sasa Department of Cardiology - Mother and Child Health Institute of Serbia, Belgrade, Serbia , Cerovic, Ivana Department of Cardiology - Mother and Child Health Institute of Serbia, Belgrade, Serbia , Ristic, Snezana Intensive Care Unit - Mother and Child Health Institute of Serbia, Belgrade, Serbia , Nesic, Dejan Institute of Medical Physiology “Rihard Burian”, Belgrade, Serbia
Abstract :
Background: In multisystem inflammatory syndrome in children (MIS‑C) temporarily associated with coronavirus
disease‑19 (COVID‑19), myocardial damage has been reported. Materials and Methods: A retrospective observational cohort
study included children under 18 who had a myocardial injury related to COVID‑19 treated in mother and child health institute
from April 2020 to August 2020. Myocardial injury related to COVID‑19 was manifested by elevated serum cardiac troponin
and NT‑proBNP with LV dysfunction, arrhythmias, and coronary arteries (CAs) dilatation or aneurysms. During the short‑term
follow‑up, cardiac testing (electrocardiography, laboratory analysis, echocardiography, 24‑h Holter monitoring, exercise stress test,
and cardiac magnetic resonance) was performed. Results: Six male adolescents (14.7 ± 2.4 years) were included in the analysis (2/6
had MIS‑C shock syndrome). All patients had elevated acute‑phase reactants and NT‑proBNP, whereas troponins were elevated in
5/6 patients. Echocardiography revealed left ventricular (LV) systolic dysfunction (EF 45.2 ± 6.9%); 2/6 had dilated CAs. IVIG was
prescribed to all patients with MIS‑C. Four patients required inotropic drug support. During hospitalization, a significant reduction
of CRP, LDH, NT‑proBNP, and D‑dimer (P < 0.05) was registered. LV systolic function recovery was registered 3 days after applied
therapy (P < 0.001). None of the patients developed dilated cardiomyopathy or CA aneurysms. Conclusions: With early recognition
and adequate MIS‑C therapy, children recovered entirely, maintained in the short‑term follow‑up period.
Keywords :
Adolescents , multisystem inflammatory syndrome in children , myocarditis , SARS‑CoV‑2
