TY - JOUR
T1 - Cardiac abnormalities seen in pediatric patients during the SARS-COV2 pandemic
T2 - An international experience
AU - Clark, Bradley C.
AU - Sanchez-De-toledo, Joan
AU - Bautista-Rodriguez, Carles
AU - Choueiter, Nadine
AU - Lara, Diego
AU - Kang, Hechaan
AU - Mohsin, Shazia
AU - Fraisse, Alain
AU - Cesar, Sergi
AU - Shaikh, Abdul Sattar
AU - Escobar-Diaz, Maria C.
AU - Hsu, Daphne T.
AU - Randanne, Paula C.
AU - Aslam, Nadeem
AU - Kleinmahon, Jake
AU - Lamour, Jacqueline M.
AU - Johnson, Jonathan N.
AU - Sarquella-Brugada, Georgia
AU - Chowdhury, Devyani
N1 - Publisher Copyright:
© 2020, American Heart Association Inc.. All rights reserved.
PY - 2020/11/3
Y1 - 2020/11/3
N2 - Background During the SARS-CoV2 pandemic, there has been increase in hyperinflammatory presentation in previously healthy children with a variety of cardiac manifestations. Our objective is to describe the cardiac manifestations found in an international cohort of 55 pediatric cases with multi-system inflammatory syndrome (MIS-C) during the SARS-CoV2 pandemic. Methods and Results We reviewed data on previously healthy pediatric patients (=18 years) with structurally normal hearts who presented at hospitals in the United States, United Kingdom, Spain and Pakistan with MIS-C and had consultation with a pediatric cardiologist. Data collected included demographics, clinical presentation, laboratory values, electrocardiographic abnormalities, echocardiographic findings and initial therapies. A total of 55 patients presented with MIS-C. Thirty-five patients (64%) had evidence of decreased left ventricular function, 17 (31%) had valvulitis, 12 (22%) with pericardial effusion and 11 (20%) with coronary abnormalities. Twenty-seven (49%) required ICU admission and 24 (44%) had evidence of shock. Eleven patients (20%) fulfilled complete Kawasaki disease criteria and had lower NT pro-BNP, D-dimer and ferritin levels compared with those who did not fulfill criteria. Electrophysiologic abnormalities occurred in 6 patients and included complete atrioventricular (AV) block, transient AV block and ventricular tachycardia. Conclusions We describe the first international cohort of pediatric patients with MIS-C during the SARS-CoV2 pandemic with a range of cardiac manifestations. This paper brings awareness and alertness to the global medical community to recognize these children during the pandemic and understand the need for early cardiology evaluation and follow-up.
AB - Background During the SARS-CoV2 pandemic, there has been increase in hyperinflammatory presentation in previously healthy children with a variety of cardiac manifestations. Our objective is to describe the cardiac manifestations found in an international cohort of 55 pediatric cases with multi-system inflammatory syndrome (MIS-C) during the SARS-CoV2 pandemic. Methods and Results We reviewed data on previously healthy pediatric patients (=18 years) with structurally normal hearts who presented at hospitals in the United States, United Kingdom, Spain and Pakistan with MIS-C and had consultation with a pediatric cardiologist. Data collected included demographics, clinical presentation, laboratory values, electrocardiographic abnormalities, echocardiographic findings and initial therapies. A total of 55 patients presented with MIS-C. Thirty-five patients (64%) had evidence of decreased left ventricular function, 17 (31%) had valvulitis, 12 (22%) with pericardial effusion and 11 (20%) with coronary abnormalities. Twenty-seven (49%) required ICU admission and 24 (44%) had evidence of shock. Eleven patients (20%) fulfilled complete Kawasaki disease criteria and had lower NT pro-BNP, D-dimer and ferritin levels compared with those who did not fulfill criteria. Electrophysiologic abnormalities occurred in 6 patients and included complete atrioventricular (AV) block, transient AV block and ventricular tachycardia. Conclusions We describe the first international cohort of pediatric patients with MIS-C during the SARS-CoV2 pandemic with a range of cardiac manifestations. This paper brings awareness and alertness to the global medical community to recognize these children during the pandemic and understand the need for early cardiology evaluation and follow-up.
KW - Cardiac dysfunction
KW - Coronary abnormalities
KW - Multi-system inflammatory syndrome (MIS-C)
KW - Pediatric
KW - SARS-CoV2
UR - http://www.scopus.com/inward/record.url?scp=85095674494&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85095674494&partnerID=8YFLogxK
U2 - 10.1161/JAHA.120.018007
DO - 10.1161/JAHA.120.018007
M3 - Article
C2 - 32957826
AN - SCOPUS:85095674494
SN - 2047-9980
VL - 9
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 21
M1 - e018007
ER -