{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T07:28:50Z","timestamp":1771658930196,"version":"3.50.1"},"reference-count":22,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T00:00:00Z","timestamp":1626307200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2022,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1047951121003140_as1\"><jats:title>Background:<\/jats:title><jats:p>Coronavirus disease 2019 (COVID-19) is responsible for significant lung disease in adults. Despite mild manifestations in most children, multisystem inflammatory syndrome (MIS-C) associated with COVID-19 is well described in older children with cardiac manifestations. However, MIS-C-related cardiac manifestations are not as well described in younger children.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951121003140_as2\"><jats:title>Methods:<\/jats:title><jats:p>The study is a retrospective analysis of MIS-C patients under the age of 5 years admitted between May and November 2020 to a single centre. Included cases fulfilled the case definition of MIS-C according to Royal College of Pediatrics and Child Health criteria with laboratory, electrocardiogram, or echocardiographic evidence of cardiac disease. Collected data included patients\u2019 demographics, laboratory results, echocardiographic findings, management, and outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951121003140_as3\"><jats:title>Results:<\/jats:title><jats:p>Out of 16 MIS-C cases under 5 years of age, 10 (62.5%) had cardiac manifestations with a median age of 12 months, 9 (90%) were previously healthy. Cardiac manifestations included coronary arterial aneurysms or ectasia in five (50%) cases, two (20%) with isolated myopericarditis, coronary ectasia with myocarditis in two (20%), and supraventricular tachycardia in one (10%). Intravenous immunoglobulins were given in all cases with coronary involvement or myocarditis. The median duration of hospitalisation was 7 (6\u201314) days; two (20%) cases with cardiac disease were mechanically ventilated and mortality in MIS-C cases below 5\u00a0years was 12.5%. Normalisation of systolic function occurred in half of the affected cases within 1 week and reached 100% by 30\u00a0days of follow-up.<\/jats:p><\/jats:sec><jats:sec id=\"S1047951121003140_as4\"><jats:title>Conclusions:<\/jats:title><jats:p>MIS-C associated with SARS-CoV-2 has a high possibility of serious associated cardiac manifestations in children under the age of 5\u00a0years with mortality and\/or long-term morbidities such as coronary aneurysms even in previously healthy children.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1047951121003140","type":"journal-article","created":{"date-parts":[[2021,7,15]],"date-time":"2021-07-15T08:49:00Z","timestamp":1626338940000},"page":"800-805","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["Cardiac implications of multisystem inflammatory syndrome associated with COVID-19 in children under the age of 5 years"],"prefix":"10.1017","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9115-910X","authenticated-orcid":false,"given":"Shaimaa","family":"Rakha","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ali","family":"Sobh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amira H.","family":"Hager","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mona","family":"Hafez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gehan A.","family":"Alsawah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Magdi","family":"Abuelkheir","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mayada Sabry","family":"Zeid","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed","family":"Nahas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0745-5388","authenticated-orcid":false,"given":"Hala","family":"Elmarsafawy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2021,7,15]]},"reference":[{"key":"S1047951121003140_ref22","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.119.012897"},{"key":"S1047951121003140_ref12","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2021756"},{"key":"S1047951121003140_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(20)30651-4"},{"key":"S1047951121003140_ref15","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000484"},{"key":"S1047951121003140_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.08.056"},{"key":"S1047951121003140_ref18","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2020.100527"},{"key":"S1047951121003140_ref2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)30628-0"},{"key":"S1047951121003140_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/S2352-4642(20)30175-9"},{"key":"S1047951121003140_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(20)31103-X"},{"key":"S1047951121003140_ref1","unstructured":"1. Cucinotta, D , Vanelli, M. WHO declares COVID-19 a pandemic. Acta Biomed 2020; 91: 157\u2013160."},{"key":"S1047951121003140_ref10","doi-asserted-by":"publisher","DOI":"10.1007\/s00246-020-02391-2"},{"key":"S1047951121003140_ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2020.09.016"},{"key":"S1047951121003140_ref3","unstructured":"3. World Health Organization. Multisystem inflammatory syndrome in children and adolescents with COVID-19. Available at: https:\/\/www.who.int\/publications\/i\/item\/ multisystem-inflammatory-syndrome-in-childrenand-adolescents-with-covid-19. Accessed August 23, 2020."},{"key":"S1047951121003140_ref4","unstructured":"4. CDC Health Alert Network. Multisystem inflammatory syndrome in children (MIS-C) associated with coronavirus disease 2019 (COVID-19). Available at: https:\/\/emergency.cdc.gov\/han\/2020\/han00432.asp. Accessed July 30, 2020."},{"key":"S1047951121003140_ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-020-03766-6"},{"key":"S1047951121003140_ref5","unstructured":"5. RCPCH. Paediatric multisystem inflammatory syndrome temporally associated with COVID-19 (PIMS) \u2013 guidance for clinicians. https:\/\/www.rcpch.ac.uk\/resources\/paediatric-multisystem-inflammatory-syndrome-temporally-associated-covid-19-pims-guidance."},{"key":"S1047951121003140_ref20","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.2091"},{"key":"S1047951121003140_ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m2094"},{"key":"S1047951121003140_ref17","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.120.048360"},{"key":"S1047951121003140_ref14","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2018.00079"},{"key":"S1047951121003140_ref21","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2021680"},{"key":"S1047951121003140_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2010.03.019"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951121003140","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T08:24:19Z","timestamp":1652775859000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951121003140\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,15]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2022,5]]}},"alternative-id":["S1047951121003140"],"URL":"https:\/\/doi.org\/10.1017\/s1047951121003140","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,7,15]]},"assertion":[{"value":"\u00a9 The Author(s), 2021. 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