Abstract
Objective This study aims to investigate the management of children diagnosed with “multisystem
inflammatory syndrome” (MIS-C) potentially associated with coronavirus disease 2019
(COVID-19) at a tertiary health center.
Methods This is a retrospective review of 34 children who were diagnosed with MIS-C at the
pediatrics department of the study center from August 2021 to December 2021. Data
related to age, sex, body mass index, vital findings, laboratory data, clinical symptoms,
ultrasonography, and echocardiography findings were acquired from hospital records.
Cardiac markers were compared with respect to clinical symptoms and imaging.
Results Fever (91.2%), rash (50%), and abdominal pain (44.1%) were the most observed symptoms.
Echocardiography visualized mild mitral regurgitation in 12 patients (35.3%), pericardial
effusion in 9 patients (26.5%), and mild coronary dilatation in 9 patients (26.5%).
All patients received corticosteroids, whereas acetylsalicylic acid was prescribed
in 29 patients (85.3%) and intravenous immunoglobulins were administered in 21 patients
(61.8%). Serum probrain natriuretic peptide concentrations were significantly higher
in MIS-C patients with rash than those without rash (9,592.2 ± 7,764.5 vs. 1,501.2 ± 1,385.4
pg/mL, p = 0.021). Serum troponin T concentrations were significantly higher in MIS-C patients
with ileitis than those without ileitis (0.026 ± 0.024 vs. 0.008 ± 0.003 µg/L, p = 0.013). Serum troponin T concentrations were also significantly higher in MIS-C
patients with pericardial effusion than those without pericardial effusion (0.022 ± 0.020
vs. 0.008 ± 0.007 µg/L, p = 0.036).
Conclusion The presence of rash and sonographic visualization of ileitis might act as signs
for cardiac involvement in children exposed to COVID-19. To assess the cardiac involvement
in MIS-C patients, cardiac enzymes should be measured and echocardiography examination
should be performed.
Keywords child - COVID-19 - inflammation - SARS-CoV-2
