Children with COVID-related MIS-C fully recover within months
Children who developed COVID-19-related multisystem inflammatory syndrome (MIS-C) saw their heart function fully return within three months, according to a new study published in the Journal of the American Heart Association.
MIS-C, a new condition that first surfaced during the COVID-19 pandemic, affects children four to six weeks after they were exposed to COVID-19. While it has many of the same symptoms as Kawasaki disease, inflammation is more intense and pervasive with MIS-C.
“There is limited data at this time about how frequently and how long we should monitor heart function during the recovery state of MIS-C after the child leaves the hospital,” senior author Anirban Banerjee, MD, a professor of clinical pediatrics at the University of Pennsylvania Perelman School of Medicine, said in a prepared statement. “Given that MIS-C was identified as a result of the COVID-19 pandemic, treatment protocols have not yet been standardized and follow-up care varies greatly, which may lead to confusion and anxiety among families of patients and their care team. Our research team hoped to provide some guidance and reduce the ambiguity on optimal care approaches, especially as it relates to sports participation."
Researchers evaluated 60 children hospitalized in Philadelphia with MIS-C between April 2020 and January 2021. Sixty percent of patients were male, and the average patient age was 10 years old. All patients received intravenous immunoglobulin and/or systemic steroids.
Echocardiographic and clinical data from medical records were reviewed as well as demographic factors, testing, treatment and hospital outcomes.
The authors found that systolic and diastolic function in the left ventricle and systolic function in the right ventricle improved within the first week, with continued improvement and complete normalization observed by three months.
In addition, 81% of patients lost a little contractile function in the left ventricle during the acute phase of illness, but contraction function normalized within a few months.
“Recovery among these children was excellent,” Banerjee said. “These results have important implications for our healthcare teams managing care for children with MIS-C."
In addition, the authors added, these findings suggest children could gradually return to playing sports within three or four months.
"Tests needed for clearance include electrocardiogram and echocardiogram," Banerjee said. "We also recommend cardiac MRI for children who have highly abnormal baseline cardiac MRI during the acute stage or show evidence of continued severe left ventricle dysfunction.”
Read the full study here.