Haghighi Aski Behzad, Manafi Anari Ali, Abolhasan Choobdar Farhad, Zareh Mahmoudabadi Ramin, Sakhaei Maryam
Department of Pediatrics, Ali Asghar Children's Hospital, Iran University of Medical Sciences, Tehran, Iran.
Iran University of Medical Science- Aliasgar Children Hospital, Iran.
Int J Cardiol Heart Vasc. 2021 Apr;33:100764. doi: 10.1016/j.ijcha.2021.100764. Epub 2021 Mar 22.
Cardiac defects due to multisystem inflammatory syndrome in children (MIS-C) have been abundantly reported leading high morbidity among children affected by Covid-19. We aimed to systematically assess the incidence of such cardiac abnormalities due to MIS-C in children suffering Covid-19.
The manuscript databases including Medline, Web of knowledge, Google scholar, Scopus, and Cochrane were deeply searched by the two blinded investigators for all eligible studies based on the relevant keywords. The risk of bias for each study was assessed according to QUADAS-2 tool. Statistical analysis was performed using the Comprehensive Meta Analysis (CMA) software.
In final, 21 articles (including 916 children) were eligible for the final analysis that all yielded good quality and none of the citation was determined to have high risk of bias. Considering studies focusing different cardiac abnormalities related to MIS-C yielded a pooled prevalence of 38.0% for significant left ventricular dysfunction, 20.0% for coronary aneurism or dilatation, 28.1% for ECG abnormalities or cardiac arrhythmias, 33.3% for raised serum troponin level and 43.6% for raised proBNP/BNP level.
Although cardiac abnormalities among children suffering Covid-19 are uncommon, in the context of the MIS-C can be common and therefore potentially serious and life threatening.
儿童多系统炎症综合征(MIS-C)所致心脏缺陷已有大量报道,在感染新冠病毒的儿童中发病率较高。我们旨在系统评估新冠病毒感染儿童中由MIS-C导致的此类心脏异常的发生率。
两名盲法研究者根据相关关键词,对包括Medline、Web of knowledge、谷歌学术、Scopus和Cochrane在内的手稿数据库进行深入检索,以查找所有符合条件的研究。根据QUADAS-2工具评估每项研究的偏倚风险。使用综合Meta分析(CMA)软件进行统计分析。
最终,21篇文章(包括916名儿童)符合最终分析条件,所有文章质量均良好,且未确定任何一篇文献存在高偏倚风险。考虑到聚焦与MIS-C相关的不同心脏异常的研究,显著左心室功能障碍的合并患病率为38.0%,冠状动脉瘤或扩张为20.0%,心电图异常或心律失常为28.1%,血清肌钙蛋白水平升高为33.3%,脑钠肽前体/脑钠肽水平升高为43.6%。
尽管新冠病毒感染儿童中的心脏异常并不常见,但在MIS-C的情况下可能很常见,因此可能很严重且危及生命。