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One of the great fears of this pandemic has been the impact of serious SARS-CoV-2 on the little ones.
Although it is true that the
multisystem inflammatory syndrome associated with covid-19
(MIS-C; also known by the acronym PIMS or, in Spanish, as SIM) develops rarely, its sequelae in different parts of the body are of concern to the pediatricians.
Now, a study published in
The Journal of the American Heart Association
points out that cardiac function in children who suffered from this syndrome recovers in three months.
The research serves to shed light on this new MIS-C pathology, which, like Covid-19, has gaps to fill, especially regarding the long-term evolution of patients.
This syndrome was described on May 1, 2020 by the British College of Pediatrics (Royal College of Paediatrics and Child Health) and on May 14 by the United States Centers for Disease Control and Prevention (CDC).
It affects children
four to six weeks after exposure to covid-19
"This picture is triggered more by an
inflammatory response than
by the virus itself," explained Rafael González, a specialist at the Spanish Society of Pediatric Intensive Care (SECIP), an entity that has a study underway on patients hospitalized for covid-19 in the pediatric ICU.
The syndrome has similarities to that of
, although it is associated with greater inflammation, which can spread to different parts of the body, including the heart, lungs, kidneys and digestive system.
In international studies it has been established that
MIS-C appears in one case per 100,000 minors
Observing the series of European and American patients, it is estimated that in 80-85% of children with this syndrome, there is an affectation of the cardiac left ventricle.
Hence the interest of this new research, which has focused on the
identified during a three-month follow-up period in children with the syndrome.
resume playing sports
of these children was
," said study senior author
, a professor of pediatrics at the University of Pennsylvania Perelman School of Medicine and an assistant cardiologist at the Heart Center of Children's Hospital of Philadelphia.
"Our findings may also provide guidance for a
gradual return to sports
after cardiac recovery three to four months later. Necessary tests include electrocardiogram and echocardiogram. We also recommend
for children who have MRI grossly abnormal initial heart rate during the acute phase or show evidence of continuing severe left ventricular dysfunction.
In this paper, retrospective data from
60 hospitalized children with MIS-C
treated at two Philadelphia hospitals between April 2020 and January 2021 were reviewed. None of the children had been diagnosed with covid-19 prior to the onset of MIS-C symptoms. c. They received treatment with
intravenous immunoglobulin and/or systemic steroids
. Those data were compared with those of 60 other children whose hearts were structurally normal and did not have a diagnosis of MIS-C or covid-19.
The study authors highlight, among their conclusions, that "according to echocardiogram images, systolic and diastolic function in the left ventricle and systolic function in the right ventricle
improved rapidly in the first week
, followed by continuous improvement and normalization. Complete at three months.
No trace of cardiac dysfunction on tests
In 81% of MIS-C cases, during the acute phase, some contractile function was lost in the left ventricle; however, that
contraction function returned to normal
at three to four months. They found no lasting abnormalities in the coronary arteries. At the start of hospitalization, "7% of patients had evidence of some heart malfunction; however, all
scans were normal at three months
' follow-up." And they conclude that using strain parameters to measure cardiac function,
there is no subclinical cardiac dysfunction
after three months.
The children were evaluated by means of different images of the heart at the beginning of the hospitalization (acute phase) and an exploration was also carried out a week after the first (subacute phase) and other additional ones, throughout the follow-up period.
, from Boston Children's Hospital, and a member of the American Heart Association (AHA) Rheumatic Fever, Endocarditis, and Kawasaki Disease committee, says of this study that "although cardiac involvement in the acute stage of disease is common, it is reassuring that
all patients returned to normal cardiac function in approximately one
week.These data tell us that, fortunately, long-
lasting cardiac injury is very rare
in MIS-C.Even in those patients with significant cardiac abnormalities in the acute phase of the disease, these changes resolved within three to four months."
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Science and Health
Boticaria GarcíaKey guidelines for a safe return to school in the middle of the sixth wave
Covid-19 Schools will only have to quarantine a class when there are five infected children
Covid-19 Pediatricians recommend quarantine in children under 5 years of age because they do not wear a mask or have access to the vaccine
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