Skip to main content
SpringerLink
Log in

Outpatient Pediatric Cardiology Follow-Up of Patients with Multisystem Inflammatory Syndrome in Children (MIS-C): A Single-Institution, Medium-Term Follow-Up Study

  • Research
  • Published:
Pediatric Cardiology Aims and scope Submit manuscript

Abstract

We are continuing to learn about the multisystem inflammatory syndrome in children (MIS-C) associated with SARS-CoV-2 infection. There are many published studies regarding the acute management of MIS-C; however, there is still much to learn regarding the long-term outcomes of patients with MIS-C. In this study, we report the outcomes of patients admitted at our institution with MIS-C and the follow-up practices in Pediatric Cardiology over the last three years. We included patients who were admitted at Lucile Packard Children’s Hospital between January 1, 2020 and October 31, 2022, who met the CDC criteria for MIS-C, and were followed in the Pediatric Cardiology Outpatient Clinic at our institution. There were 25 patients who met our inclusion criteria. Eighteen patients (72%) had their initial follow-up visit within 1–2 weeks of discharge and seven patients (28%) had their initial follow-up visit within 4–6 weeks of discharge. Six patients out of the 25 (24%) had decreased left ventricular ejection fraction (LVEF < 50%) during their hospitalization. No patients had left main coronary artery aneurysm (z-score > 2.5), two patients (8%) had proximal right coronary artery aneurysm (z-score > 2.5), and one patient (4%) had left anterior descending coronary artery aneurysm (z-score > 2.5) during hospitalization. Patients who were admitted with the diagnosis of MIS-C showed normalization of left ventricular dysfunction at their initial follow-up visit as early as 2–4 weeks after discharge. In this cohort of MIS-C patients, a 4–6-week window for the first follow-up visit after discharge seems reasonable.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

MIS-C:

Multisystem inflammatory syndrome in children

LVEF:

Left ventricular ejection fraction

Echo:

Echocardiography

CAD/CAA:

Coronary artery dilation/coronary artery aneurysm

LMCA:

Left main coronary artery

LAD:

Left anterior descending

RCA:

Right coronary artery

References

  1. CDC. Multisystem Inflammatory Syndrome (MIS) Published 2021. https://www.cdc.gov/mis/hcp/index.html

  2. McArdle AJ, Vito O, Patel H et al (2021) Treatment of multisystem inflammatory syndrome in children. N Engl J Med 385(1):11–22. https://doi.org/10.1056/nejmoa2102968

    Article  CAS  PubMed  Google Scholar 

  3. Feldstein LR, Rose EB, Horwitz SM et al (2020) Multisystem inflammatory syndrome in U.S. children and adolescents. N Engl J Med 383(4):334–346. https://doi.org/10.1056/nejmoa2021680

    Article  CAS  PubMed  Google Scholar 

  4. Alsaied T, Tremoulet AH, Burns JC et al (2021) Review of cardiac involvement in multisystem inflammatory syndrome in children. Circulation 143(1):78–88. https://doi.org/10.1161/CIRCULATIONAHA.120.049836

    Article  CAS  PubMed  Google Scholar 

  5. Farooqi KM, Chan A, Weller RJ et al (2021) Longitudinal outcomes for multisystem inflammatory syndrome in children. Pediatrics. https://doi.org/10.1542/peds.2021-051155

    Article  PubMed  Google Scholar 

  6. AAP. Multisystem inflammatory syndrome in children (MIS-C interim guidance. https://www.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/multisystem-inflammatory-syndrome-in-children-mis-c-interim-guidance/

  7. Son MB, Freidman K. COVID-19: multisystem inflammatory syndrome in children (MIS-C) management and outcome. https://www.uptodate.com/contents/covid-19-multisystem-inflammatory-syndrome-in-children-mis-c-management-and-outcome#H999319060

  8. Kache S, Schwenk H, Mathew R, et al (2020) Multisystem inflammatory syndrome in children (MIS-C) pathway exclusion criteria: multisystem inflammatory syndrome in children (MIS-C) pathway determine patient disposition based on initial presentation and work-up

  9. Son MBF, Gauvreau K, Kim S et al (2017) Predicting coronary artery aneurysms in Kawasaki disease at a North American center: an assessment of baseline z scores. J Am Heart Assoc. https://doi.org/10.1161/JAHA.116.005378

    Article  PubMed  PubMed Central  Google Scholar 

  10. Chakraborty A, Philip R, Santoso M, Naik R, Merlocco A, Johnson JN (2022) Cardiovascular magnetic resonance in children with multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19: institutional protocol-based medium-term follow-up study. Pediatr Cardiol. https://doi.org/10.1007/s00246-022-02927-8

    Article  PubMed  PubMed Central  Google Scholar 

  11. Arslan SY, Bal ZS, Bayraktaroglu S et al (2022) Cardiac assessment in children with MIS-C: late magnetic resonance imaging features. Pediatr Cardiol. https://doi.org/10.1007/s00246-022-02977-y

    Article  PubMed  PubMed Central  Google Scholar 

  12. Garbin M, Raso I, Piersanti A et al (2022) Advanced echocardiographic analysis in medium-term follow-up of children with previous multisystem inflammatory syndrome. Children. https://doi.org/10.3390/children9060917

    Article  PubMed  PubMed Central  Google Scholar 

  13. Aziz OA, Sadiq M, Qureshi AU et al (2022) Short to midterm follow-up of multi-system inflammatory syndrome in children with special reference to cardiac involvement. Cardiol Young. https://doi.org/10.1017/S1047951122000828

    Article  PubMed  Google Scholar 

  14. Patnaik S, Jain MK, Ahmed S et al (2021) Short-term outcomes in children recovered from multisystem inflammatory syndrome associated with SARS-CoV-2 infection. Rheumatol Int 41(11):1957–1962. https://doi.org/10.1007/s00296-021-04932-1

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Jhaveri S, Ahluwalia N, Kaushik S et al (2021) Longitudinal echocardiographic assessment of coronary arteries and left ventricular function following multisystem inflammatory syndrome in children. J Pediatr 228:290-293.e1. https://doi.org/10.1016/j.jpeds.2020.08.002

    Article  CAS  PubMed  Google Scholar 

  16. Barris DM, Keelan J, Ahluwalia N et al (2022) Midterm outcomes and cardiac magnetic resonance imaging following multisystem inflammatory syndrome in children. J Pediatr 241:237-241.e1. https://doi.org/10.1016/j.jpeds.2021.10.009

    Article  CAS  PubMed  Google Scholar 

  17. Das N, Hill R, Trivedi M et al (2022) Longitudinal assessment of cardiac function following multisystem inflammatory syndrome in children associated with COVID-19. Pediatr Cardiol. https://doi.org/10.1007/s00246-022-02972-3

    Article  PubMed  PubMed Central  Google Scholar 

  18. Sirico D, Basso A, Sabatino J et al (2022) Evolution of echocardiographic and cardiac magnetic resonance imaging abnormalities during follow-up in patients with multisystem inflammatory syndrome in children. Eur Heart J Cardiovasc Imaging 23(8):1066–1074. https://doi.org/10.1093/ehjci/jeac096

    Article  CAS  PubMed  Google Scholar 

  19. Capone CA, Misra N, Ganigara M et al (2021) Six month follow-up of patients with multi-system inflammatory syndrome in children. Pediatrics. https://doi.org/10.1542/peds.2021-050973

    Article  PubMed  Google Scholar 

  20. Jose JT, Selamet Tierney ES (2022) Outpatient monitoring of patients with multisystem inflammatory syndrome (MIS-C): a mini review. Front Pediatr. https://doi.org/10.3389/fped.2022.1069632

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

There are no funding sources to disclose.

Author information

Authors and Affiliations

  1. Division of Pediatric Cardiology, Lucile Packard Children’s Hospital, Stanford University Medical Center, 750 Welch Road, Palo Alto, CA, 94304, USA

    Jerin Tresa Jose & Elif Seda Selamet Tierney

Authors
  1. Jerin Tresa Jose
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Elif Seda Selamet Tierney
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JJ and ET: conceptualized the study and methodology. JJ: conducted chart review, collected data, drafted the initial manuscript text, and prepared figure 1 and tables 1-4. ET: reviewed the data, figures, and tables. All authors reviewed the final manuscript and approved the final version.

Corresponding author

Correspondence to Jerin Tresa Jose.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to disclose relevant to this article.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Jose, J.T., Tierney, E.S.S. Outpatient Pediatric Cardiology Follow-Up of Patients with Multisystem Inflammatory Syndrome in Children (MIS-C): A Single-Institution, Medium-Term Follow-Up Study. Pediatr Cardiol 45, 401–409 (2024). https://doi.org/10.1007/s00246-023-03298-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00246-023-03298-4

Keywords

Search

Navigation