[Cardiology compromise and inflammatory markers in children with Multisystemic Inflammatory Syndrome related to COVID-19 infection].

UNLABELLED: Coronavirus 2 (SARS-CoV-2) infection has spread rapidly. In pediatrics, a condition similar to shock is described named multisystem inflammatory syndrome in children (MIS-C) or pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS). The mechanisms of cardiological involvement are not clear.

OBJECTIVE: To describe cardiological in volvement and inflammatory markers in hospitalized patients with MIS-C in a tertiary hospital.

PATIENTS AND METHOD: Observational, retrospective study in children under 15 years of age with MIS-C. Demographic, clinical, and laboratory variables were collected from an electronic plat form, including troponin, B-type natriuretic peptide (proBNP), ultrasound, and electrocardio gram. Patients with / without cardiological involvement (CCC / SCC) were compared. GraphPad QuickCalcs© 2018 Software was used for statistical analysis, considering p < 0.05.

RESULTS: Thir teen patients diagnosed with MIS-C, 9 males, median age 9.5 years. All presented with fever and abdominal pain, adding one or more of the following symptoms: vomiting, exanthema, diarrhea, altered mucous membranes and/or edema. Five patients had hemodynamic compromise, 9/13 were categorized as CCC. Troponins were elevated 4.1 times in CCC (p < 0.05), median ProBNP CCC 6940 pg/ml vs 921 pg/ml in SCC (p < 0.05), median Ferritin CCC 482 vs 154 ng/ml in SCC (p < 0.01), platelets CCC 106,000 vs SCC 207,000/mm3 (p < 0.05). Echocardiogram showed pe ricardial effusion (N = 6), mild systolic dysfunction (N = 4), moderate dysfunction (N = 1) and coronary alterations (N = 3). In the ECG, 3 patients presented transient repolarization disturbance and 1 first-degree atrioventricular block. None required support with extracorporeal membrane oxygenation, with no deaths.

CONCLUSION: cardiological involvement in hospitalized children with MIS-C is frequent. Our series showed nonspecific and transitory symptoms, and hemodynamic compromise which responded early to medical treatment, with a favorable evolution. The markers in CCC patients were troponin, ProBNP, ferritin, and thrombocytopenia. The most frequent ul trasound finding was pericardial effusion. The importance of both clinical and laboratory cardio logical evaluation in these patients is evident.