RT Journal Article
T1 Myocardial involvement in children with post-COVID multisystem inflammatory syndrome: a cardiovascular magnetic resonance based multicenter international study-the CARDOVID registry.
A1 Aeschlimann, Florence A
A1 Misra, Nilanjana
A1 Hussein, Tarique
A1 Panaioli, Elena
A1 Soslow, Jonathan H
A1 Crum, Kimberly
A1 Steele, Jeremy M
A1 Huber, Steffen
A1 Marcora, Simona
A1 Brambilla, Paolo
A1 Jain, Supriya
A1 Navallas, Maria
A1 Giuli, Valentina
A1 Rücker, Beate
A1 Angst, Felix
A1 Patel, Mehul D
A1 Azarine, Arshid
A1 Caro-Domínguez, Pablo
A1 Cavaliere, Annachiara
A1 Di Salvo, Giovanni
A1 Ferroni, Francesca
A1 Agnoletti, Gabriella
A1 Bonnemains, Laurent
A1 Martins, Duarte
A1 Boddaert, Nathalie
A1 Wong, James
A1 Pushparajah, Kuberan
A1 Raimondi, Francesca
K1 Acute myocarditis
K1 CMR
K1 Children
K1 MIS-C
K1 SARS Cov-2 infection
AB Recent evidence shows an association between coronavirus disease 2019 (COVID-19) infection and a severe inflammatory syndrome in children. Cardiovascular magnetic resonance (CMR) data about myocardial injury in children are limited to small cohorts. The aim of this multicenter, international registry is to describe clinical and cardiac characteristics of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 using CMR so as to better understand the real extent of myocardial damage in this vulnerable cohort. Hundred-eleven patients meeting the World Health Organization criteria for MIS-C associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), having clinical cardiac involvement and having received CMR imaging scan were included from 17 centers. Median age at disease onset was 10.0 years (IQR 7.0-13.8). The majority of children had COVID-19 serology positive (98%) with 27% of children still having both, positive serology and polymerase chain reaction (PCR). CMR was performed at a median of 28 days (19-47) after onset of symptoms. Twenty out of 111 (18%) patients had CMR criteria for acute myocarditis (as defined by the Lake Louise Criteria) with 18/20 showing subepicardial late gadolinium enhancement (LGE). CMR myocarditis was significantly associated with New York Heart Association class IV (p = 0.005, OR 6.56 (95%-CI 1.87-23.00)) and the need for mechanical support (p = 0.039, OR 4.98 (95%-CI 1.18-21.02)). At discharge, 11/111 (10%) patients still had left ventricular systolic dysfunction. No CMR evidence of myocardial damage was found in most of our MIS-C cohort. Nevertheless, acute myocarditis is a possible manifestation of MIS-C associated with SARS-CoV-2 with CMR evidence of myocardial necrosis in 18% of our cohort. CMR may be an important diagnostic tool to identify a subset of patients at risk for cardiac sequelae and more prone to myocardial damage. The study has been registered on ClinicalTrials.gov, Identifier NCT04455347, registered on 01/07/2020, retrospectively registered.
YR 2021
FD 2021-12-30
LK https://hdl.handle.net/10668/27330
UL https://hdl.handle.net/10668/27330
LA en
DS RISalud
RD Apr 11, 2025