Division of Pediatric Cardiology, Hassenfeld Children's Hospital at NYU Langone, New York, NY, USA.
Division of Neonatology, Hassenfeld Children's Hospital at NYU Langone, New York, NY, USA.
Clin Pediatr (Phila). 2021 Feb;60(2):119-126. doi: 10.1177/0009922820961771. Epub 2020 Sep 25.
The overall severity of cardiac disease secondary to acute SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) infection in children appears to be much lower when compared with adults. However, the newly described multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19) has been associated with cardiac complications.
We reviewed the clinical course and cardiac testing results in pediatric patients hospitalized with MIS-C at 2 large hospital systems in the New York City metropolitan area over a 3-month period.
Of the 33 patients (median age 2.8 years) in the study cohort, 24 (73%) had at least one abnormality in cardiac testing: abnormal electrocardiogram (48%), elevated brain natriuretic peptide (43%), abnormal echocardiogram (30%), and/or elevated troponin (21%). Electrocardiogram and echocardiogram abnormalities all resolved by the 2-week outpatient follow-up cardiology visit.
While 73% of pediatric patients with MIS-C had evidence of abnormal cardiac testing on hospital admission in our study, all cardiac testing was normal by outpatient hospital discharge follow-up. Cardiac screening tests should be performed in all patients diagnosed with MIS-C given the high rate of abnormal cardiac findings in our study cohort.
与成年人相比,继发于急性严重急性呼吸综合征冠状病毒 2 型(SARS-CoV-2)感染的儿科心脏病的整体严重程度似乎要低得多。然而,与 2019 年冠状病毒病(COVID-19)相关的新描述的儿童多系统炎症综合征(MIS-C)与心脏并发症有关。
我们回顾了在纽约市大都市区的 2 个大型医院系统中,在 3 个月期间因 MIS-C 住院的儿科患者的临床经过和心脏检查结果。
在研究队列的 33 名患者(中位年龄 2.8 岁)中,有 24 名(73%)至少有一项心脏检查异常:心电图异常(48%)、脑钠肽升高(43%)、超声心动图异常(30%)和/或肌钙蛋白升高(21%)。心电图和超声心动图异常在 2 周的门诊随访心内科就诊时均已缓解。
虽然在我们的研究中,73%的 MIS-C 儿科患者在入院时的心脏检查存在异常证据,但所有的心脏检查在门诊出院随访时均正常。鉴于我们的研究队列中心脏异常发现率很高,应在所有诊断为 MIS-C 的患者中进行心脏筛查检查。