{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T20:39:22Z","timestamp":1793911162810,"version":"4.8.0"},"reference-count":35,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Pediatr"],"published-print":{"date-parts":[[2025,3,1]]},"abstract":"Importance<\/jats:title>Multisystem inflammatory syndrome in children (MIS-C) is a life-threatening complication of COVID-19 infection. Data on midterm outcomes are limited.<\/jats:p><\/jats:sec>Objective<\/jats:title>To characterize the frequency and time course of cardiac dysfunction (left ventricular ejection fraction [LVEF] &amp;lt;55%), coronary artery aneurysms (z<\/jats:italic> score \u22652.5), and noncardiac involvement through 6 months after MIS-C.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cohort study enrolled participants between March 2020 and January 2022 with a follow-up period of 2 years. Participants were recruited from 32 North American pediatric hospitals, and all participants met the 2020 Centers for Disease Control and Prevention case definition of MIS-C.<\/jats:p><\/jats:sec>Exposure<\/jats:title>MIS-C after COVID-19 infection.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>Outcomes included echocardiography core laboratory (ECL) assessments of LVEF and maximum coronary artery z<\/jats:italic> scores (zMax); data collection on cardiac and noncardiac sequelae during hospitalization and at 2 weeks, 6 weeks, and 6 months after discharge; and age-appropriate Patient-Reported Outcomes Measurement Information Systems (PROMIS) Global Health Instruments at follow-up. Descriptive statistics, linear regression models, and Kaplan-Meier analysis were used.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 1204 participants (median [IQR] age, 9.1 [5.6-12.7] years; 724 male [60.1%]), 325 self-identified with non-Hispanic Black race (27.0%) and 324 with Hispanic ethnicity (26.9%). A total of 548 of 1195 participants (45.9%) required vasoactive support, 17 of 1195 (1.4%) required extracorporeal membrane oxygenation, and 3 (0.3%) died during hospitalization. Of participants with echocardiograms reviewed by the ECL (n\u2009=\u2009349 due to budget constraints), 131 of 322 (42.3%) had LVEF less than 55% during hospitalization; of those with follow-up, all but 1 normalized by 6 months. Black race (vs other\/unknown race), higher C-reactive protein level, and abnormal troponin level were associated with lowest LVEF (estimate [SE], \u22123.09 [0.98]; R<\/jats:italic>2<\/jats:sup>\u2009=\u20090.14; P<\/jats:italic>\u2009=.002). Fifteen participants had coronary artery z<\/jats:italic> scores of 2.5 or greater at any time point; 1 participant had a large\/giant aneurysm. Of the 13 participants with z<\/jats:italic> scores of 2.5 or greater during hospitalization, 12 (92.3%) had normalized by 6 months. Return to greater than 90% of pre\u2013MIS-C health status (energy, sleep, appetite, cognition, and mood) was reported by 711 of 824 participants (86.3%) at 2 weeks, increasing to 548 of 576 (95.1%) at 6 months. Fatigue was the most common symptom reported at 2 weeks (141 of 889 [15.9%]), falling to 3.4% (22 of 638) by 6 months. PROMIS Global Health parent\/guardian proxy median T scores for fatigue, global health, and pain interference improved significantly from 2 weeks to 6 months (fatigue, 56.1 vs 48.9; global health, 48.8 vs 51.3; pain interference, 53.0 vs 43.3; P<\/jats:italic>\u2009&amp;lt;\u2009.001) and by the 6-week visit were at least equivalent to prepandemic population norms.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>Results of this cohort study suggest that although children and young adults with MIS-C can have severe disease during the acute phase, most recovered quickly and had a reassuring midterm prognosis.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapediatrics.2024.5466","type":"journal-article","created":{"date-parts":[[2025,1,13]],"date-time":"2025-01-13T16:01:39Z","timestamp":1736784099000},"page":"293","source":"Crossref","is-referenced-by-count":27,"title":["Six-Month Outcomes in the Long-Term Outcomes After the Multisystem Inflammatory Syndrome in Children Study"],"prefix":"10.1001","volume":"179","author":[{"given":"Dongngan T.","family":"Truong","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, University of Utah and Primary Children\u2019s Hospital, Salt Lake City"},{"name":"Now with Children\u2019s Healthcare of Atlanta Cardiology, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia L.","family":"Trachtenberg","sequence":"additional","affiliation":[{"name":"Carelon Research, Newton, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenwei","family":"Hu","sequence":"additional","affiliation":[{"name":"Carelon Research, Newton, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gail D.","family":"Pearson","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Friedman","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Harvard Medical School and Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arash A.","family":"Sabati","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, University of Arizona College of Medicine and Phoenix Children\u2019s Hospital, Phoenix"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Dionne","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Harvard Medical School and Boston Children\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew E.","family":"Oster","sequence":"additional","affiliation":[{"name":"Children\u2019s Healthcare of Atlanta Cardiology, Emory University School of Medicine, Atlanta, Georgia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett R.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Cardiology, New York-Presbyterian\/Columbia University Irving Medical Center, New York"},{"name":"Now with Division of Cardiology, Department of Pediatrics, Icahn School of Medicine and Mount Sinai Kravis Children\u2019s Hospital, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Block","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, Medical College of Wisconsin and Children\u2019s Hospital of Wisconsin, Milwaukee"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara T.","family":"Bradford","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Pediatrics, Louisiana State University and Children\u2019s Hospital of New Orleans, New Orleans"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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