Cardiopulmonary Exercise Testing in Children and Young Adolescents after a Multisystem Inflammatory Syndrome: Physical Deconditioning or Residual Pathology?

Gentili, Federica; Calcagni, Giulio; Cantarutti, Nicoletta; Manno, Emma Concetta; Cafiero, Giulia; Tranchita, Eliana; Salvati, Annamaria; Palma, Paolo; Giordano, Ugo; Drago, Fabrizio; Turchetta, Attilio

doi:10.3390/jcm12062375

Open AccessArticle

Cardiopulmonary Exercise Testing in Children and Young Adolescents after a Multisystem Inflammatory Syndrome: Physical Deconditioning or Residual Pathology?

by

Federica Gentili

¹,

Giulio Calcagni

^1,*

,

Nicoletta Cantarutti

¹

,

Emma Concetta Manno

²,

Giulia Cafiero

¹

,

Eliana Tranchita

¹,

Annamaria Salvati

¹,

Paolo Palma

²

,

Ugo Giordano

¹

,

Fabrizio Drago

^1,†

and

Attilio Turchetta

^1,†

¹

Complex Unit of Cardiology S. Paolo, Palidoro, Santa Marinella and Arrhythmology, Clinical Area of Fetal, Neonatal and Cardiological Sciences, Bambino Gesù Children’s Hospital, IRCCS, L.go S. Onofrio 4, 00165 Rome, Italy

²

Complex Unit of Clinical Immunology and Vaccinology, Clinical Area of University Hospital Pediatrics, Bambino Gesù Children’s Hospital, IRCCS, L.go S. Onofrio 4, 00165 Rome, Italy

^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

J. Clin. Med. 2023, 12(6), 2375; https://doi.org/10.3390/jcm12062375

Submission received: 19 January 2023 / Revised: 2 March 2023 / Accepted: 15 March 2023 / Published: 19 March 2023

(This article belongs to the Special Issue COVID-19-Associated Myocardial Injury and Other Cardiovascular Diseases)

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Abstract

Multisystem inflammatory syndrome in children (MIS-C) is a serious health condition that imposes a long-term follow-up. The purpose of our pilot study is to evaluate the usefulness of the cardiopulmonary stress test (CPET) in the follow-up after MIS-C. All patients admitted for MIS-C in our hospital in the 12 months preceding the date of observation were considered for inclusion in the study. Pre-existing cardio-respiratory diseases and/or the lack of collaboration were the exclusion criteria. At enrolment, each subject passed a cardiological examination, rest ECG, echocardiogram, 24 h Holter-ECG, blood tests, and a CPET complete of spirometry. A total of 20 patients met the inclusion criteria (11.76 ± 3.29 years, 13 male). In contrast to the normality of all second-level investigations, CPET showed lower-than-expected peakVO₂ and peak-oxygen-pulse values (50% of cases) and higher-than-expected VE/VCO_2-slope values (95% of cases). A statistically significant inverse correlation was observed between P-reactive-protein values at admission and peakVO₂/kg values (p = 0.034), uric acid values at admission, and peakVO₂ (p = 0.011) or peak-oxygen-pulse expressed as a percentage of predicted (p = 0.021), NT-proBNP values at admission and peakVO₂ expressed as a percentage of predicted (p = 0.046). After MIS-C (4–12 months) relevant anomalies can be observed at CPET, which can be a valuable tool in the follow-up after this condition.

Keywords: multisystem inflammatory syndrome in children (MIS-C); cardiopulmonary stress test (CPET); COVID-19; SARS-CoV-2; coronavirus 2; oxygen uptake; VE/VCO₂ slope; follow-up

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MDPI and ACS Style

Gentili, F.; Calcagni, G.; Cantarutti, N.; Manno, E.C.; Cafiero, G.; Tranchita, E.; Salvati, A.; Palma, P.; Giordano, U.; Drago, F.; et al. Cardiopulmonary Exercise Testing in Children and Young Adolescents after a Multisystem Inflammatory Syndrome: Physical Deconditioning or Residual Pathology? J. Clin. Med. 2023, 12, 2375. https://doi.org/10.3390/jcm12062375

AMA Style

Gentili F, Calcagni G, Cantarutti N, Manno EC, Cafiero G, Tranchita E, Salvati A, Palma P, Giordano U, Drago F, et al. Cardiopulmonary Exercise Testing in Children and Young Adolescents after a Multisystem Inflammatory Syndrome: Physical Deconditioning or Residual Pathology? Journal of Clinical Medicine. 2023; 12(6):2375. https://doi.org/10.3390/jcm12062375

Chicago/Turabian Style

Gentili, Federica, Giulio Calcagni, Nicoletta Cantarutti, Emma Concetta Manno, Giulia Cafiero, Eliana Tranchita, Annamaria Salvati, Paolo Palma, Ugo Giordano, Fabrizio Drago, and et al. 2023. "Cardiopulmonary Exercise Testing in Children and Young Adolescents after a Multisystem Inflammatory Syndrome: Physical Deconditioning or Residual Pathology?" Journal of Clinical Medicine 12, no. 6: 2375. https://doi.org/10.3390/jcm12062375

APA Style

Gentili, F., Calcagni, G., Cantarutti, N., Manno, E. C., Cafiero, G., Tranchita, E., Salvati, A., Palma, P., Giordano, U., Drago, F., & Turchetta, A. (2023). Cardiopulmonary Exercise Testing in Children and Young Adolescents after a Multisystem Inflammatory Syndrome: Physical Deconditioning or Residual Pathology? Journal of Clinical Medicine, 12(6), 2375. https://doi.org/10.3390/jcm12062375

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Cardiopulmonary Exercise Testing in Children and Young Adolescents after a Multisystem Inflammatory Syndrome: Physical Deconditioning or Residual Pathology?

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