{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T21:59:09Z","timestamp":1747173549810,"version":"3.40.5"},"reference-count":29,"publisher":"Cambridge University Press (CUP)","issue":"10","license":[{"start":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T00:00:00Z","timestamp":1639094400000},"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":[[2022,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S104795112100456X_as1\"><jats:title>Introduction:<\/jats:title><jats:p>We describe a cohort of children referred with multisystem inflammatory syndrome in children associated with severe acute respiratory <jats:italic>syndrome coronavirus 2<\/jats:italic> and compare this cohort with a 2019 cohort of children with Kawasaki disease.<\/jats:p><\/jats:sec><jats:sec id=\"S104795112100456X_as2\"><jats:title>Methods:<\/jats:title><jats:p>We conducted a retrospective cohort study of 2019 and 2020 referrals to the inflammatory cardiology service at Great Ormond Street Hospital for Children. We compared cardiac and inflammatory parameters of a sub-section of the 2020 cohort who presented with reduced left ventricular ejection fraction with the remainder of the cohort.<\/jats:p><\/jats:sec><jats:sec id=\"S104795112100456X_as3\"><jats:title>Results:<\/jats:title><jats:p>Referrals significantly increased between February and June 2020 compared to 2019 (19.8\/30 days versus 3.9\/30 days). Frequency of coronary artery aneurysms (11\/79 (13.9%) versus 7\/47 (14.9%)) or severe coronary artery aneurysms (6\/79 (7.6%) versus 3\/47 (6.4%)) was similar between 2020 and 2019, respectively. The 2020 cohort was older (median age 9.07 years versus 2.38 years), more likely to be of Black, Asian, or other minority ethnic group (60\/76 (78.9%) versus 25\/42 (59.5%)), and more likely to require inotropic support (22 (27.5%) versus 0 (0%)). Even children with significantly reduced left ventricular ejection fraction demonstrated complete recovery of cardiac function within 10 days (mean 5.25 days \u00b1 2.7).<\/jats:p><\/jats:sec><jats:sec id=\"S104795112100456X_as4\"><jats:title>Discussion:<\/jats:title><jats:p>We observed complete recovery of myocardial dysfunction and an overall low rate of permanent coronary sequelae, indicating that the majority of children with multisystem inflammatory syndrome in children are unlikely to encounter long-term cardiac morbidity. Although the frequency of myocardial dysfunction and inotropic support requirement is not consistent with a diagnosis of Kawasaki disease, the frequency of coronary artery abnormalities and severe coronary artery abnormalities suggests a degree of phenotypic overlap.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s104795112100456x","type":"journal-article","created":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T09:40:12Z","timestamp":1639129212000},"page":"1585-1591","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":3,"title":["Cardiac outcomes in severe acute respiratory syndrome coronavirus-2-associated multisystem inflammatory syndrome at a tertiary paediatric hospital"],"prefix":"10.1017","volume":"32","author":[{"given":"Filip","family":"Kucera","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8780-2297","authenticated-orcid":false,"given":"Craig","family":"Laurence","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jacob","family":"Simmonds","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Javier","family":"Gavela","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetyana","family":"Bodnar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Brogan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aparna","family":"Hoskote","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Skellett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karyn","family":"Moshal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alasdair","family":"Bamford","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sachin","family":"Khambadkone","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2021,12,10]]},"reference":[{"key":"S104795112100456X_ref8","unstructured":"8. Royal College of Paediatrics and Child Health [Internet]. London: Guidance: Paediatric multisystem inflammatory syndrome temporally associated with COVID-19, 2020. Retrieved January 4 2021, from https:\/\/www.rcpch.ac.uk\/sites\/default\/files\/2020-05\/COVID-19-Paediatric-multisystem-%20inflammatory%20syndrome-20200501.pdf"},{"key":"S104795112100456X_ref23","doi-asserted-by":"crossref","first-page":"100527","DOI":"10.1016\/j.eclinm.2020.100527","article-title":"Multisystem inflammatory syndrome in children: a systematic review","volume":"26","author":"Ahmed","year":"2020","journal-title":"EClinicalMedicine"},{"key":"S104795112100456X_ref19","doi-asserted-by":"crossref","first-page":"e927","DOI":"10.1161\/CIR.0000000000000484","article-title":"Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American Heart Association","volume":"135","author":"McCrindle","year":"2017","journal-title":"Circulation"},{"key":"S104795112100456X_ref2","doi-asserted-by":"crossref","first-page":"e20200702","DOI":"10.1542\/peds.2020-0702","article-title":"Epidemiology of COVID-19 among children in China","volume":"145","author":"Dong","year":"2020","journal-title":"Pediatrics"},{"key":"S104795112100456X_ref16","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1016\/S2352-4642(20)30215-7","article-title":"Intensive care admissions of children with paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in the UK: a multicentre observational study","volume":"4","author":"Davies","year":"2020","journal-title":"Lancet Child Adolesc Heal"},{"key":"S104795112100456X_ref25","doi-asserted-by":"crossref","first-page":"2124","DOI":"10.1093\/eurheartj\/ehaa396","article-title":"Acute myocardial injury, MINOCA, or myocarditis? Improving characterization of coronavirus-associated myocardial involvement","volume":"41","author":"Peretto","year":"2020","journal-title":"Eur Heart J"},{"key":"S104795112100456X_ref1","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1001\/jama.2020.1585","article-title":"Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan","volume":"323","author":"Wang","year":"2020","journal-title":"China JAMA"},{"key":"S104795112100456X_ref15","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.jpeds.2020.06.044","article-title":"Characteristics, cardiac involvement, and outcomes of multisystem inflammatory disease of childhood (MIS-C) associated with SARS-CoV-2 infection","volume":"224","author":"Capone","year":"2020","journal-title":"J. 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Pediatric Infect Dis Soc"},{"key":"S104795112100456X_ref4","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1161\/CIRCULATIONAHA.120.049836","article-title":"Review of cardiac involvement in multisystem inflammatory syndrome in children","volume":"143","author":"Alsaied","year":"2021","journal-title":"Circulation"},{"key":"S104795112100456X_ref28","doi-asserted-by":"crossref","first-page":"e89","DOI":"10.1542\/peds.2004-2190","article-title":"Coronary artery dilation among patients presenting with systemic-onset juvenile idiopathic arthritis","volume":"116","author":"Binstadt","year":"2005","journal-title":"Pediatrics"},{"key":"S104795112100456X_ref14","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1016\/j.cell.2020.09.016","article-title":"The immunology of multisystem inflammatory syndrome in children with COVID-19","volume":"183","author":"Consiglio","year":"2020","journal-title":"Cell"},{"key":"S104795112100456X_ref18","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1161\/CIRCULATIONAHA.107.690875","article-title":"Coronary artery involvement in children with Kawasaki disease","volume":"116","author":"McCrindle","year":"2007","journal-title":"Circulation"},{"key":"S104795112100456X_ref5","doi-asserted-by":"crossref","first-page":"1607","DOI":"10.1016\/S0140-6736(20)31094-1","article-title":"Hyperinflammatory shock in children during COVID-19 pandemic","volume":"395","author":"Riphagen","year":"2020","journal-title":"Lancet"},{"key":"S104795112100456X_ref7","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1161\/CIRCULATIONAHA.120.048360","article-title":"Acute heart failure in multisystem inflammatory syndrome in children in the context of global SARS-CoV-2 pandemic","volume":"142","author":"Belhadjer","year":"2020","journal-title":"Circulation"},{"key":"S104795112100456X_ref29","doi-asserted-by":"crossref","first-page":"789","DOI":"10.1016\/j.jpeds.2011.05.013","article-title":"Coronary artery dilation in sickle cell disease","volume":"159","author":"Nicholson","year":"2011","journal-title":"J Pediatr"},{"key":"S104795112100456X_ref22","doi-asserted-by":"crossref","first-page":"115","DOI":"10.1161\/CIRCULATIONAHA.113.001372","article-title":"Diagnosis and treatment of myocarditis in children in the current era","volume":"129","author":"Canter","year":"2014","journal-title":"Circulation"},{"key":"S104795112100456X_ref6","first-page":"1","article-title":"An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study","volume":"6736","author":"Verdoni","year":"2020","journal-title":"Lancet"},{"key":"S104795112100456X_ref21","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1093\/rheumatology\/key344","article-title":"European consensus-based recommendations for the diagnosis and treatment of Kawasaki disease \u2013 the SHARE initiative","volume":"58","author":"de Graeff","year":"2019","journal-title":"Rheumatology"},{"key":"S104795112100456X_ref10","unstructured":"10. Freedman S, Godfred-Cato S, Gorman, R, et al, World Health Organization [internet]. Multisystem inflammatory syndrome in children and adolescents with COVID-19: Scientific Brief, 2020. Retrieved January 4 2021, from https:\/\/www.who.int\/news-room\/commentaries\/detail\/multisystem-inflammatory-syndrome-in-children-and-adolescents-with-covid-19"},{"key":"S104795112100456X_ref9","unstructured":"9. Centres for Disease Control and Prevention [Internet]. Multisystem Inflammatory Syndrome in Children (MIS-C) Associated with Coronavirus Disease 2019 (COVID-19). Washington, DC, 2020. 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