Special Issue "Cardiac Manifestation in Multisystem Inflammatory Syndrome in Children during Global SARS-CoV-2 Pandemic"

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Global and Public Health".

Deadline for manuscript submissions: closed (31 August 2021).

Special Issue Editor

Dr. Bibhuti B. Das
E-Mail Website
Guest Editor
Department of Pediatric Cardiology, Children’s of Mississippi, University of Mississippi Medical Center, Jackson, MS 39211, USA
Interests: pediatric cardiology; pediatric cardiomyopathy; heart failure; mechanical circulatory support; heart transplantation; exercise testing
Special Issues and Collections in MDPI journals

Special Issue Information

Dear Colleagues,

A pediatric multisystem inflammatory syndrome (MIS-C), with side effects ranging from fever and inflammation to myocardial injury, shock, and the coronary development of artery aneurysms, which presents and progresses similarly to patients with Kawasaki Disease and KD Shock syndrome, has been reported following SARS-CoV-2 infection. Vaccine trials are ongoing; current studies include children as young as 12 years of age. It is critical that pediatric patients of all ages be included in trials as quickly as possible, including those who belong to racial, ethnic, and cultural groups that have been disproportionately affected by the pandemic or who have underlying conditions that place them at increased risk for developing severe COVID-19 infection.

To date, there have been more than 103 million confirmed cases of coronavirus 2019 (COVID-19) disease worldwide, with more than 2.3 million deaths. The COVID-19 pandemic has had a catastrophic impact on global health. Children are less severely affected but not immune to SARS-CoV-2. In this context, it is important to study diverse cardiac involvement due to SARS-CoV-2 infection and highlight the significant variability of COVID-19 presentations in children.

Dr. Bibhuti B. Das
Guest Editor

Manuscript Submission Information

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Keywords

  • SARS-CoV-2 infection
  • COVID-19
  • inflammatory cardiomyopathy
  • multisystem inflammatory syndrome in children

Published Papers (3 papers)

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Research

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Article
Cardiac Manifestations in Children with SARS-COV-2 Infection: 1-Year Pediatric Multicenter Experience
Children 2021, 8(8), 717; https://doi.org/10.3390/children8080717 - 23 Aug 2021
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Abstract
Since the spread of COVID-19, pediatric patients were initially considered less affected by SARS-COV-2, but current literature reported subsets of children with multisystem inflammatory syndrome (MIS-C). This study aims to describe the cardiac manifestation of SARS-COV-2 infection in a large cohort of children [...] Read more.
Since the spread of COVID-19, pediatric patients were initially considered less affected by SARS-COV-2, but current literature reported subsets of children with multisystem inflammatory syndrome (MIS-C). This study aims to describe the cardiac manifestation of SARS-COV-2 infection in a large cohort of children admitted to two Italian pediatric referral centers. Between March 2020 and March 2021, we performed a cardiac evaluation in 294 children (mean age 9 ± 5.9 years, male 60%) with active or previous SARS-COV-2 infection. Twenty-six showed ECG abnormalities: 63 repolarization anomalies, 13 Long QTc, five premature ventricular beats, two non-sustained ventricular tachycardia, and one atrial fibrillation. In total, 146 patients underwent cardiac biomarkers: NT-proBNP was elevated in 57, troponin in 34. An echocardiogram was performed in 98, showing 54 cardiac anomalies: 27 left-ventricular dysfunction, 42 pericarditis, 16 coronaritis. MIS-C was documented in 46 patients (mean age 9 ± 4.8 years, male 61%) with cardiac manifestations in 97.8%: 27 ventricular dysfunctions, 32 pericarditis, 15 coronaritis, 3 arrhythmias. All patients recovered, and during follow-up, no cardiac anomalies were recorded. Our experience showed that cardiac involvement is not rare in children with SARS-COV-2, and occurred in almost all patients with MIS-C. However, patients’ recovery is satisfactory and no additional events were reported during FU. Full article
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Review

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Review
Myocarditis and Pericarditis Following mRNA COVID-19 Vaccination: What Do We Know So Far?
Children 2021, 8(7), 607; https://doi.org/10.3390/children8070607 - 18 Jul 2021
Cited by 1 | Viewed by 1945
Abstract
This is a cross-sectional study of 29 published cases of acute myopericarditis following COVID-19 mRNA vaccination. The most common presentation was chest pain within 1–5 days after the second dose of mRNA COVID-19 vaccination. All patients had an elevated troponin. Cardiac magnetic resonance [...] Read more.
This is a cross-sectional study of 29 published cases of acute myopericarditis following COVID-19 mRNA vaccination. The most common presentation was chest pain within 1–5 days after the second dose of mRNA COVID-19 vaccination. All patients had an elevated troponin. Cardiac magnetic resonance imaging revealed late gadolinium enhancement consistent with myocarditis in 69% of cases. All patients recovered clinically rapidly within 1–3 weeks. Most patients were treated with non-steroidal anti-inflammatory drugs for symptomatic relief, and 4 received intravenous immune globulin and corticosteroids. We speculate a possible causal relationship between vaccine administration and myocarditis. The data from our analysis confirms that all myocarditis and pericarditis cases are mild and resolve within a few days to few weeks. The bottom line is that the risk of cardiac complications among children and adults due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection far exceeds the minimal and rare risks of vaccination-related transient myocardial or pericardial inflammation. Full article
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Other

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Case Report
SARS-CoV-2 Myocarditis in a High School Athlete after COVID-19 and Its Implications for Clearance for Sports
Children 2021, 8(6), 427; https://doi.org/10.3390/children8060427 - 21 May 2021
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Abstract
This case report describes a high school athlete with palpitation, myalgia, fatigue, and dyspnea on exertion after SARS-CoV-2 infection with evidence of myocarditis by cardiac magnetic resonance (CMR), but echocardiography and troponin were normal. This case is unusual as the standard cardiac tests [...] Read more.
This case report describes a high school athlete with palpitation, myalgia, fatigue, and dyspnea on exertion after SARS-CoV-2 infection with evidence of myocarditis by cardiac magnetic resonance (CMR), but echocardiography and troponin were normal. This case is unusual as the standard cardiac tests recommended by the American Heart Association for sports clearance, including ECG, echocardiography, and cardiac biomarkers, were normal. Still, she continued to be symptomatic after mild COVID-19. The CMR was performed to evaluate her unexplained palpitation and showed patchy myocardial edema two months after her initial SARS-CoV-2 infection. In this case, the diagnosis of myocardial involvement would be missed by normal echocardiograms and cardiac bio-markers without CMR. Because acute myocarditis is a risk factor for sudden death in competitive athletes, pediatric cardiologists should consider performing additional tests such as cardiac MRI in symptomatic COVID-19 patients, even if cardiac biomarkers and echocardiograms are normal. Full article
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