{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T20:39:23Z","timestamp":1793911163057,"version":"4.8.0"},"reference-count":35,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVES<\/jats:title>\n                    <jats:p>The risk of persistent multisystem dysfunction following multisystem inflammatory syndrome in children (MIS-C), a severe postviral complication of COVID-19, remains unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We investigated long-term outcomes in patients younger than 21\u00a0years with MIS-C (n\u2009=\u2009173) vs without MIS-C (n\u2009=\u200914\u2009190) up to 4.5\u00a0years after COVID-19 in the Montefiore Health System (March 2020 to August 2024). MIS-C status was based on International Classification of Diseases, Tenth Revision codes and Centers for Disease Control and Prevention and World Health Organization criteria. 1:2 propensity score matching and Cox proportional hazards regression with multivariable adjustment were performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Compared with patients without, patients with MIS-C showed markedly higher risk of cardiovascular disorders (adjusted hazard ratio [aHR]\u2009=\u200913.88 [4.69\u201341.07], P\u2009&amp;lt;\u2009.001), hypertension (aHR\u2009=\u20098.86 [4.12\u201319.06], P\u2009&amp;lt;\u2009.001), gastrointestinal disorders (aHR\u2009=\u20099.48 [2.66\u201333.71], P\u2009&amp;lt;\u2009.001), respiratory disorders (aHR\u2009=\u20093.46 [2.21\u20135.42], P\u2009&amp;lt;\u2009.001), and neurological disorders (aHR\u2009=\u20092.02 [1.22\u20133.34], P\u2009=\u2009.007). Preexisting hypertension (9.25% of patients with MIS-C vs 6.94% of controls) significantly predicted cardiovascular, neurological, respiratory, and gastrointestinal outcomes. Each 1-year increase in age was associated with increased risk of shock (aHR\u2009=\u20091.06 [1.02\u20131.11]) and chronic kidney disease (CKD) (aHR\u2009=\u20091.06 [1.01\u20131.12]). Preexisting diabetes (1.73% of patients with MIS-C) was associated with a 49-fold increased risk of CKD. Kaplan-Meier analysis showed higher persistent risk in the MIS-C group across all outcomes, ranging from 6.8% for CKD to 35.2% for respiratory disorders. Sensitivity analysis using different definitions of MIS-C corroborated our main findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>MIS-C is associated with broad multisystem morbidity persisting years after acute COVID-19, challenging earlier reports of transient illness. Structured long-term follow-up, including routine blood pressure monitoring, neurological and mental-health screening, and cardiovascular and renal surveillance, with coordinated multidisciplinary care is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/peds.2025-075578","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:02:46Z","timestamp":1781049766000},"source":"Crossref","is-referenced-by-count":3,"title":["Long-Term Outcomes of Multisystem Inflammatory Syndrome in Children up to 4.5\u00a0Years After COVID-19"],"prefix":"10.1542","volume":"158","author":[{"given":"Shiv","family":"Mehrotra-Varma","sequence":"first","affiliation":[{"name":"1Department of Radiology, Montefiore Health System and Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hien Quang","family":"Nguyen","sequence":"additional","affiliation":[{"name":"1Department of Radiology, Montefiore Health System and Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonya","family":"Henry","sequence":"additional","affiliation":[{"name":"1Department of Radiology, Montefiore Health System and Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessilin","family":"Collins","sequence":"additional","affiliation":[{"name":"1Department of Radiology, Montefiore Health System and Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jai","family":"Mehrotra-Varma","sequence":"additional","affiliation":[{"name":"1Department of Radiology, Montefiore Health System and Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sagar","family":"Changela","sequence":"additional","affiliation":[{"name":"1Department of Radiology, Montefiore Health System and Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim Q.","family":"Duong","sequence":"additional","affiliation":[{"name":"1Department of Radiology, Montefiore Health System and Albert Einstein College of Medicine, Bronx, New York"},{"name":"2Center for Health Data Innovation, Montefiore Health System and Albert Einstein College of Medicine, Bronx, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"2026102203520965000_r1","article-title":"Multisystem inflammatory syndrome in children and adolescents with COVID-19","author":"World Health Organization"},{"issue":"4","key":"2026102203520965000_r2","doi-asserted-by":"crossref","first-page":"1","DOI":"10.15585\/mmwr.rr7104a1","article-title":"Council of state and territorial epidemiologists\/CDC surveillance case definition for multisystem inflammatory 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