AUTHOR=Kostik Mikhail M. , Bregel Liudmila V. , Avrusin Ilia S. , Efremova Olesya S. , Belozerov Konstantin E. , Dondurei Elena A. , Kornishina Tatiana L. , Isupova Eugenia A. , Abramova Natalia N. , Felker Eugeniy Yu , Masalova Vera V. , Santimov Andrey V. , Kozlov Yuri A. , Barakin Alexander O. , Snegireva Ludmila S. , Konstantinova Julia , Vilnits Alla A. , Bekhtereva Maria K. , Argunova Vera M. , Matyunova Alla E. , Sleptsova Polina A. , Burtseva Tatyana E. , Shprakh Vladimir V. , Boyko Tatyana V. , Kalashnikova Olga V. , Chasnyk Vyacheslav G. TITLE=Heart Involvement in Multisystem Inflammatory Syndrome, Associated With COVID-19 in Children: The Retrospective Multicenter Cohort Data JOURNAL=Frontiers in Pediatrics VOLUME=10 YEAR=2022 URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2022.829420 DOI=10.3389/fped.2022.829420 ISSN=2296-2360 ABSTRACT=Objectives

Heart involvement in multisystem inflammatory syndrome associated with COVID-19 in children (MIS-C) is a new challenging problem, requiring fast and reliable diagnostics and appropriate treatment. The aim of this study is to describe heart involvement in patients with MIS-C.

Study Design

In this retrospective, multicenter cohort study, data of 122 patients were included. All patients met WHO and CDC criteria of MIS-C.

Results

Various types of heart involvement in MIS-C patients were observed. Patients with solely coronary artery lesions (CAL, n = 10, 8.2%) had typical features of Kawasaki disease: younger age, thrombocytosis and normal ferritin level, without giant CA aneurysms, thrombosis, myocardial infarction, shock, and ICU admission. Patients with solely myocardial involvement (MI, n = 30, 24.6%) had an older onset age, elevated ferritin, LDH, the highest D-dimer, H score, and thrombocytopenia level. The following clinical signs were associated with MI: gastrointestinal and central nervous system disorder, sore throat, swelling face, splenomegaly, shock, and treatment in the intensive care unit required. Patients with a combination of CAL and MI (n = 10, 8.2%) had symptoms similar to patients with solely MI, except for impressive thrombocytopenia. Shock and ICU admission were found in 34.7% of patients without heart involvement (n = 72, 59%). One major criterion [troponin > 32 pg/ml (52 points)] or at least two minor criteria [face swelling (32 points) and D-Dimer > 1,300 ng/ml (29 points)] were associated with MI (>32 points) with a sensitivity of 67.5% and a specificity of 88.9%.

Conclusion

The above-suggested criteria can be added to routine diagnostic procedures to confirm MI in MIS-C patients.