{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T04:12:24Z","timestamp":1792123944523,"version":"4.4.0"},"reference-count":22,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2020,8,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Cardiac injury and myocarditis have been described in adults with coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children is typically minimally symptomatic. We report a series of febrile pediatric patients with acute heart failure potentially associated with SARS-CoV-2 infection and the multisystem inflammatory syndrome in children as defined by the US Centers for Disease Control and Prevention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Over a 2-month period, contemporary with the SARS-CoV-2 pandemic in France and Switzerland, we retrospectively collected clinical, biological, therapeutic, and early outcomes data in children who were admitted to pediatric intensive care units in 14 centers for cardiogenic shock, left ventricular dysfunction, and severe inflammatory state.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Thirty-five children were identified and included in the study. Median age at admission was 10 years (range, 2\u201316 years). Comorbidities were present in 28%, including asthma and overweight. Gastrointestinal symptoms were prominent. Left ventricular ejection fraction was &lt;30% in one-third; 80% required inotropic support with 28% treated with extracorporeal membrane oxygenation. Inflammation markers were suggestive of cytokine storm (interleukin-6 median, 135 pg\/mL) and macrophage activation (D-dimer median, 5284 ng\/mL). Mean BNP (B-type natriuretic peptide) was elevated (5743 pg\/mL). Thirty-one of 35 patients (88%) tested positive for SARS-CoV-2 infection by polymerase chain reaction of nasopharyngeal swab or serology. All patients received intravenous immunoglobulin, with adjunctive steroid therapy used in one-third. Left ventricular function was restored in the 25 of 35 of those discharged from the intensive care unit. No patient died, and all patients treated with extracorporeal membrane oxygenation were successfully weaned.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Children may experience an acute cardiac decompensation caused by severe inflammatory state after SARS-CoV-2 infection (multisystem inflammatory syndrome in children). Treatment with immunoglobulin appears to be associated with recovery of left ventricular systolic function.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.120.048360","type":"journal-article","created":{"date-parts":[[2020,5,17]],"date-time":"2020-05-17T12:10:43Z","timestamp":1589717443000},"page":"429-436","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":934,"title":["Acute Heart Failure in Multisystem Inflammatory Syndrome in Children in the Context of Global SARS-CoV-2 Pandemic"],"prefix":"10.1161","volume":"142","author":[{"given":"Zahra","family":"Belhadjer","sequence":"first","affiliation":[{"name":"M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)."},{"name":"Universit\u00e9 de Paris, France (Z.B., L.H., S.R., D.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mathilde","family":"M\u00e9ot","sequence":"additional","affiliation":[{"name":"M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanny","family":"Bajolle","sequence":"additional","affiliation":[{"name":"M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diala","family":"Khraiche","sequence":"additional","affiliation":[{"name":"M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoine","family":"Legendre","sequence":"additional","affiliation":[{"name":"M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samya","family":"Abakka","sequence":"additional","affiliation":[{"name":"M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanne","family":"Auriau","sequence":"additional","affiliation":[{"name":"M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marion","family":"Grimaud","sequence":"additional","affiliation":[{"name":"M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehdi","family":"Oualha","sequence":"additional","affiliation":[{"name":"M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., D.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"Beghetti","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, University Hospital, Geneva, Switzerland (M.B., J.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Wacker","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology Unit, University Hospital, Geneva, Switzerland (M.B., J.W.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline","family":"Ovaert","sequence":"additional","affiliation":[{"name":"Paediatric and Congenital Cardiology Department, M3C Regional CHD Center, La Timone University Hospital, Marseille, France (C.O.)."},{"name":"INSERM UMR 1251, Marseille Medical Genetics, University of Aix-Marseille, Marseille, France (C.O.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastien","family":"Hascoet","sequence":"additional","affiliation":[{"name":"M3C Marie-Lannelongue Hospital, Paediatric and Congenital Cardiac Surgery Department, Groupe Hospitalier Saint-Joseph, Paris Sud University, Plessis-Robinson, France (S.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ma\u00eblle","family":"Selegny","sequence":"additional","affiliation":[{"name":"Pediatric-Cardiology, Amiens-Picardie University Hospital, Amiens, France (M.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Malekzadeh-Milani","sequence":"additional","affiliation":[{"name":"M3C-Necker Enfants Malades, AP-HP, Paris, France (Z.B., M.M., F.B., D.K., A.L., S.A., J.A., M.G., M.O., S.M.-M., A.M., L.H., S.R., 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Strasbourg, France (L.B., J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeanne","family":"Bordet","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, University of Strasbourg, France (L.B., J.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Di Filippo","sequence":"additional","affiliation":[{"name":"Pediatric Cardiology and Congenital Heart Disease Department, Cardiovascular Louis-Pradel Hospital, Hospices Civils de Lyon, France (S.D.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Mauran","sequence":"additional","affiliation":[{"name":"Department of Paediatric and Congenital Cardiology, Center de comp\u00e9tence M3C, American Memorial Hospital, CHU de Reims, France (P. Mauran)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvie","family":"Falcon-Eicher","sequence":"additional","affiliation":[{"name":"CHU Dijon-Bourgogne, Dijon, France (S.F.-E.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Beno\u00eet","family":"Thambo","sequence":"additional","affiliation":[{"name":"CHU Bordeaux, Department of Pediatric Cardiology, Bordeaux-II University, France (J.-B.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Lefort","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de Cardiologie P\u00e9diatrique, H\u00f4pital des Enfants Gatien de Clocheville, INSERM UMR 1069 et Universit\u00e9 Fran\u00e7ois Rabelais, Tours, France (B.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Moceri","sequence":"additional","affiliation":[{"name":"Department of Cardiology, H\u00f4pital Pasteur, CHU de Nice, France (P. 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