key: cord-336144-e7hvp9wy
authors: Friedman, Kevin G.; Harrild, David M.; Newburger, Jane W.
title: Cardiac Dysfunction in Multisystem Inflammatory Syndrome in Children: A Call to Action
date: 2020-10-27
journal: J Am Coll Cardiol
DOI: 10.1016/j.jacc.2020.09.002
sha: 
doc_id: 336144
cord_uid: e7hvp9wy

[Figure: see text]

infection. Indeed, only 2% of confirmed cases have occurred in persons <18 years, and the mortality rate in children is 0.5% (1) . However, the early comfort that healthy children were largely spared from critical COVID-19-related illness has been shattered in recent months by descriptions of a severe postinfectious syndrome among children exposed to SARS-CoV-2, with clinical features resembling both Kawasaki disease (KD) and toxic shock syndrome.

This emerging syndrome has been defined by health organizations worldwide and named multisystem inflammatory syndrome in children associated with COVID-19 (MIS-C) by the US Centers for Disease Control and Prevention (CDC). MIS-C prevalence typically surges 3 to 6 weeks after the peak of COVID-19 in a geographic region (2) (3) (4) (5) . This timing, together with findings of positive serology and negative NTPCR in most affected children suggest that pathogenesis is related to host immune response and hyperinflammation (3) (4) (5) (6) .

Involvement of the cardiovascular system in MIS-C is common (80% to 85% of cases) and is a primary To date, the trajectory of recovery of systolic function has been characterized only in small retrospective case series (2) (3) (4) (5) (6) (7) (8) (9) . However, early reports suggest that LVEF normalizes in most patients within 1 to 2 weeks after initial presentation (7, 8) . (33% with EF 30% to 54% and 5% with EF <30%). 

Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019-COVID-NET, 14 States

Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2

Distinct clinical and immunological features of SARS-COV-2-induced multisystem inflammatory syndrome in children

Multisystem inflammatory syndrome in children in New York state

Multisystem inflammatory syndrome in U.S. children and adolescents

COVID-19-associated multisystem inflammatory syndrome in children -United States

Acute heart failure in multisystem inflammatory syndrome in children in the context of global SARS-CoV-2 pandemic

Multimodality cardiac evaluation in children and young adults with multisystem inflammation associated with COVID-19

Hyperinflammatory shock in children during COVID-19 pandemic

Echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 in the United States

KEY WORDS coronary artery abnormality, COVID-19, deformation, echocardiography, multisystem inflammatory syndrome in children (MIS-C)

Cardiac Dysfunction in MIS-C