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J Pediatr Infect Dis 2023; 18(02): 088-093
DOI: 10.1055/s-0042-1760411
Original Article

Rash and Gastrointestinal Dysfunction May Indicate Cardiac Involvement in Children with Multisystem Inflammatory System Associated with Coronavirus Disease 2019

Ayhan Pektaş
1   Division of Pediatric Cardiology, Department of Pediatrics, Afyonkarahisar Health Sciences University Hospital, Afyonkarahisar, Türkiye
,
Ayşegül Bükülmez
2   Division of Pediatric Gastroenterology, Department of Pediatrics, Afyonkarahisar Health Sciences University Hospital, Afyonkarahisar, Türkiye
,
Mehmet Çeleğen 
3   Division of Pediatric Intensive Care Unit, Department of Pediatrics, Afyonkarahisar Health Sciences University Hospital, Afyonkarahisar, Türkiye
,
İbrahim Eker
4   Division of Pediatric Hematology, Department of Pediatrics, Afyonkarahisar Health Sciences University Hospital, Afyonkarahisar, Türkiye
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Abstract

Objective This study aims to investigate the management of children diagnosed with “multisystem inflammatory syndrome” (MIS-C) potentially associated with coronavirus disease 2019 (COVID-19) at a tertiary health center.

Methods This is a retrospective review of 34 children who were diagnosed with MIS-C at the pediatrics department of the study center from August 2021 to December 2021. Data related to age, sex, body mass index, vital findings, laboratory data, clinical symptoms, ultrasonography, and echocardiography findings were acquired from hospital records. Cardiac markers were compared with respect to clinical symptoms and imaging.

Results Fever (91.2%), rash (50%), and abdominal pain (44.1%) were the most observed symptoms. Echocardiography visualized mild mitral regurgitation in 12 patients (35.3%), pericardial effusion in 9 patients (26.5%), and mild coronary dilatation in 9 patients (26.5%). All patients received corticosteroids, whereas acetylsalicylic acid was prescribed in 29 patients (85.3%) and intravenous immunoglobulins were administered in 21 patients (61.8%). Serum probrain natriuretic peptide concentrations were significantly higher in MIS-C patients with rash than those without rash (9,592.2 ± 7,764.5 vs. 1,501.2 ± 1,385.4 pg/mL, p = 0.021). Serum troponin T concentrations were significantly higher in MIS-C patients with ileitis than those without ileitis (0.026 ± 0.024 vs. 0.008 ± 0.003 µg/L, p = 0.013). Serum troponin T concentrations were also significantly higher in MIS-C patients with pericardial effusion than those without pericardial effusion (0.022 ± 0.020 vs. 0.008 ± 0.007 µg/L, p = 0.036).

Conclusion The presence of rash and sonographic visualization of ileitis might act as signs for cardiac involvement in children exposed to COVID-19. To assess the cardiac involvement in MIS-C patients, cardiac enzymes should be measured and echocardiography examination should be performed.

Keywords

child - COVID-19 - inflammation - SARS-CoV-2


Publication History

Received: 31 May 2022

Accepted: 04 December 2022

Article published online:
05 January 2023

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