Long-Term Follow-Up of Cardiac Magnetic Resonance Imaging in Multisystem İnflammatory Syndrome in Children Associated with COVID-19: A Prospective Study

Abstract

Background The researchers identified cases of multisystem inflammatory syndrome in children, which was linked to COVID-19 starting in 2020. Multisystem inflammatory syndrome in children is associated with significant cardiovascular morbidity in the acute phase. A small number of articles in the literature have recorded the long-term myocardial effects of multisystem inflammatory syndrome in children treated in pediatric intensive care units. Our study aimed to investigate the late cardiac outcomes of multisystem inflammatory syndrome in children using cardiac magnetic resonance imaging. Results A median of 16 months had passed after the onset of the disease in multisystem inflammatory syndrome in children. Ejection fraction (%), cardiac output (L/min), stroke volume (mL), end-diastolic volume index (mL/m(2) ), cardiac index (L/min/m(2) ), and stroke volume index (mL/m(2) ) were all significantly lower in multisystem inflammatory syndrome in children. During at least a 1-year follow-up, minor cardiac damage was discovered in 26% of individuals who underwent cardiac magnetic resonance imaging. In addition, none of the 23 infants showed symptoms of late gadolinium enhancement or pericardial effusion. While all patients underwent cardiac magnetic resonance imaging, the transthoracic echocardiogram evaluation revealed normal heart function. Conclusion Our study found no evidence of late gadolinium enhancement, which indicates cardiac fibrosis in cardiac magnetic resonance imaging performed after a prolonged hospitalization in multisystem inflammatory syndrome in children who were admitted to the intensive care unit. This absence of late gadolinium enhancement is a reassuring finding, suggesting that the long-term cardiac outcomes of multisystem inflammatory syndrome in children may not be as severe as initially feared. However, the long-term cardiac magnetic resonance imaging results revealed mild left ventricular dysfunction in these patients that could not be detected via a transthoracic echocardiogram.