Please use this identifier to cite or link to this item: https://repository.monashhealth.org/monashhealthjspui/handle/1/52770
Conference/Presentation Title: Acute and short-term cardiac profile of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19: prospective surveillance from the paediatric active enhance disease surveillance (PAEDS) network, Australia 2020-2023.
Authors: Varma S.;Wang N.;Hunter G.;Blyth C.;Finucane C.;Francis J.;Francis L.;Wong S.;Ayer J.;Wood N.;Britton P.;Carr J.
Institution: (Varma, Wang, Hunter, Blyth, Finucane, Francis, Francis, Wong, Ayer, Wood, Britton, Carr) Monash Children's Hospital, Melbourne, Australia
Presentation/Conference Date: 19-Nov-2024
Copyright year: 2024
Publication information: Cardiology in the Young. Conference: 8th World Congress of Pediatric Cardiology and Cardiac Surgery, WCPCCS 2023. Washington, DC United States. 34(Supplement 1) (pp S1026), 2024. Date of Publication: May 2024.
Journal: Cardiology in the Young
Abstract: Background: The clinical syndrome of MIS-C can have myocardial dysfunction, coronary artery abnormalities and conduction defects. Further evidence is required to inform the application of archetypal Kawasaki disease (KD) management to MIS-C despite clinical similarities. We describe the acute and short-term cardiac sequelae of MIS-C in Australia during 2020-2023. Method(s): Prospective surveillance of MIS-C cases across 4 of 8 PAEDS network paediatric hospital sites between Feb 2020 - May 2023. A consensus panel classified MIS-C cases as 'confirmed' or 'possible' based on the PAEDS case definition. All included cases had acute and convalescent (6 week) echocardiograms. Result(s): 79 MIS-C cases were included (mean age 7.3 years, 59% male) out of a total of 175 cases identified nationally. There were no deaths. Inotropes were used in 8 (10.8%) patients, none required ECMO. At presentation, 19 (24.0%) had systolic dysfunction; 13 (16.5%) had at least one dilated coronary artery (z-score > 2), of which 2 (2.5%) had aneurysms. The left main and left anterior descending coronary arteries were most involved. Only 4 (4.4%) patients had both systolic dysfunction and coronary abnormality. Pericardial effusion was present in 22 (27.8%) subjects. Elevated troponin-I was associated with systolic dysfunction (OR 6.8, p<0.003) but lacked specificity (66%) and sensitivity (78%). Treatment included corticosteroids alone (15.1%), IVIG alone (6.0%) or both (77.3%). At 6-week follow-up, no patients had residual systolic dysfunction, pericardial effusion or coronary aneurysms. Mild coronary artery dilatation (z-score < 2.5) was present in 2 (2.5%) patients, both of whom had coronary abnormality in the acute phase. Conclusion(s): Most cardiac sequelae of MIS-C resolves after the acute illness. All coronary aneurysms regressed; only 2 of 79 patients had residual mild coronary ectasia. None had late coronary abnormality without acute coronary changes. This data will inform cardiac follow-up after MIS-C. Data collection is ongoing and will be updated.
Conference Name: 8th World Congress of Pediatric Cardiology and Cardiac Surgery, WCPCCS 2023
Conference Start Date: 2023-08-27
Conference End Date: 2023-09-01
Conference Location: Washington, DC, United States
DOI: http://monash.idm.oclc.org/login?url=https://dx.doi.org/10.1017/S1047951124024478
URI: https://repository.monashhealth.org/monashhealthjspui/handle/1/52770
Type: Conference Abstract
Subjects: cardiomyopathy
coronary artery aneurysm
coronary artery dilatation
coronavirus disease 2019
echocardiography
Type of Clinical Study or Trial: Observational study (cohort, case-control, cross sectional, or survey)
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