Outcomes of Multisystem Inflammatory Syndrome in Children (MIS-C) Save
A nationwide cohort study of patients with multisystem inflammatory syndrome in children (MIS-C), a life-threatening complication of COVID-19 infection, showed that many had severe disease during the acute phase, but most recovered quickly and had a reassuring midterm prognosis.
This cohort study enrolled patients under age 19 yrs, meeting the 2020 Centers for Disease Control and Prevention case definition of MIS-C. Participants were recruited from 32 North American pediatric hospitals, between March 2020 and January 2022 and followed for a period of 2 years. Primary outcomes characterized the frequency and time course of cardiac dysfunction (left ventricular ejection fraction [LVEF] <55%), coronary artery aneurysms (z score ≥2.5), and noncardiac involvement through 6 months after MIS-C.
The cohort included 1204 patients (median 9.1 [5.6-12.7] years; males 60%). Severity indicated by 46% who required vasoactive support, 1.4% required extracorporeal membrane oxygenation, and 0.3% died during hospitalization.
- Of those with ECHO 42% had LVEF less than 55% during hospitalization; of those with follow-up, all but 1 normalized by 6 months.
- Lowest LVEF associated with - Black race, higher C-reactive protein levels, and abnormal troponin levels
- Fifteen participants had coronary artery z scores of 2.5 or greater
- 1 participant had a large/giant aneurysm.
- Return to pre–MIS-C health status was seen in 86% at 2 weeks; increasing to 95% at 6 months
- Fatigue fell to 3.4% by 6 months.
The mid-term outcomes of patients with MIS-C following COVID-19 was very good in this cohort study .
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