BACKGROUND: In spring 2020, a novel hyperinflammatory process associated with severe acute respiratory syndrome coronavirus 2 multisystem inflammatory syndrome in children (MIS-C) was described. The long-term impact remains unknown. We report longitudinal outcomes from a New York interdisciplinary follow-up program. METHODS: All children <21 years of age, admitted to NewYork-Presbyterian with MIS-C in 2020, were included. Children were followed at 1 to 4 weeks, 1 to 4 months, and 4 to 9 months postdischarge. RESULTS: In total, 45 children were admitted with MIS-C. The median time to last follow-up was 5.8 months (interquartile range 1.3-6.7). Of those admitted, 76% required intensive care and 64% required vasopressors and/or inotropes. On admission, patients exhibited significant nonspecific inflammation, generalized lymphopenia, and thrombocytopenia. Soluble interleukin (IL) IL-2R, IL-6, IL-10, IL-17, IL-18, and C-X-C Motif Chemokine Ligand 9 were elevated. A total of 80% (n = 36) had at least mild and 44% (n = 20) had moderate-severe echocardiographic abnormalities including coronary abnormalities (9% had a z score of 2-2.5; 7% had a z score > 2.5). Whereas most inflammatory markers normalized by 1 to 4 weeks, 32% (n = 11 of 34) exhibited persistent lymphocytosis, with increased double-negative T cells in 96% of assessed patients (n = 23 of 24). By 1 to 4 weeks, only 18% (n = 7 of 39) had mild echocardiographic findings; all had normal coronaries. At 1 to 4 months, the proportion of double-negative T cells remained elevated in 92% (median 9%). At 4 to 9 months, only 1 child had persistent mild dysfunction. One had mild mitral and/or tricuspid regurgitation. CONCLUSIONS: Although the majority of children with MIS-C present critically ill, most inflammatory and cardiac manifestations in our cohort resolved rapidly.
BACKGROUND: In spring 2020, a novel hyperinflammatory process associated with severe acute respiratory syndrome coronavirus 2multisystem inflammatory syndrome in children (MIS-C) was described. The long-term impact remains unknown. We report longitudinal outcomes from a New York interdisciplinary follow-up program. METHODS: All children <21 years of age, admitted to NewYork-Presbyterian with MIS-C in 2020, were included. Children were followed at 1 to 4 weeks, 1 to 4 months, and 4 to 9 months postdischarge. RESULTS: In total, 45 children were admitted with MIS-C. The median time to last follow-up was 5.8 months (interquartile range 1.3-6.7). Of those admitted, 76% required intensive care and 64% required vasopressors and/or inotropes. On admission, patients exhibited significant nonspecific inflammation, generalized lymphopenia, and thrombocytopenia. Soluble interleukin (IL) IL-2R, IL-6, IL-10, IL-17, IL-18, and C-X-C Motif Chemokine Ligand 9 were elevated. A total of 80% (n = 36) had at least mild and 44% (n = 20) had moderate-severe echocardiographic abnormalities including coronary abnormalities (9% had a z score of 2-2.5; 7% had a z score > 2.5). Whereas most inflammatory markers normalized by 1 to 4 weeks, 32% (n = 11 of 34) exhibited persistent lymphocytosis, with increased double-negative T cells in 96% of assessed patients (n = 23 of 24). By 1 to 4 weeks, only 18% (n = 7 of 39) had mild echocardiographic findings; all had normal coronaries. At 1 to 4 months, the proportion of double-negative T cells remained elevated in 92% (median 9%). At 4 to 9 months, only 1 child had persistent mild dysfunction. One had mild mitral and/or tricuspid regurgitation. CONCLUSIONS: Although the majority of children with MIS-C present critically ill, most inflammatory and cardiac manifestations in our cohort resolved rapidly.
Authors: Michael P DiLorenzo; Kanwal M Farooqi; Amee M Shah; Alexandra Channing; Jamie K Harrington; Thomas J Connors; Karen Martirosyan; Usha S Krishnan; Anne Ferris; Rachel J Weller; Donna L Farber; Joshua D Milner; Mark Gorelik; Erika B Rosenzweig; Brett R Anderson Journal: Pediatr Radiol Date: 2022-10-18
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Authors: Thais T Fink; Heloisa H S Marques; Bruno Gualano; Livia Lindoso; Vera Bain; Camilla Astley; Fernanda Martins; Denise Matheus; Olivia M Matsuo; Priscila Suguita; Vitor Trindade; Camila S Y Paula; Sylvia C L Farhat; Patricia Palmeira; Gabriela N Leal; Lisa Suzuki; Vicente Odone Filho; Magda Carneiro-Sampaio; Alberto José S Duarte; Leila Antonangelo; Linamara R Batisttella; Guilherme V Polanczyk; Rosa Maria R Pereira; Carlos Roberto R Carvalho; Carlos A Buchpiguel; Ana Claudia L Xavier; Marilia Seelaender; Clovis Artur Silva; Maria Fernanda B Pereira; Adriana M E Sallum; Alexandra V M Brentani; Álvaro José S Neto; Amanda Ihara; Andrea R Santos; Ana Pinheiro M Canton; Andreia Watanabe; Angélica C Dos Santos; Antonio C Pastorino; Bernadette D G M Franco; Bruna Caruzo; Carina Ceneviva; Carolina C M F Martins; Danilo Prado; Deipara M Abellan; Fabiana B Benatti; Fabiana Smaria; Fernanda T Gonçalves; Fernando D Penteado; Gabriela S F de Castro; Guilherme S Gonçalves; Hamilton Roschel; Ilana R Disi; Isabela G Marques; Inar A Castro; Izabel M Buscatti; Jaline Z Faiad; Jarlei Fiamoncini; Joaquim C Rodrigues; Jorge D A Carneiro; Jose A Paz; Juliana C Ferreira; Juliana C O Ferreira; Katia R Silva; Karina L M Bastos; Katia Kozu; Lilian M Cristofani; Lucas V B Souza; Lucia M A Campos; Luiz Vicente R F Silva Filho; Marcelo T Sapienza; Marcos S Lima; Marlene P Garanito; Márcia F A Santos; Mayra B Dorna; Nadia E Aikawa; Nadia Litvinov; Neusa K Sakita; Paula V V Gaiolla; Paula Pasqualucci; Ricardo K Toma; Simone Correa-Silva; Sofia M Sieczkowska; Marta Imamura; Silvana Forsait; Vera A Santos; Yingying Zheng Journal: Clinics (Sao Paulo) Date: 2021-11-26 Impact factor: 2.898
Authors: Michael P Dilorenzo; Kanwal M Farooqi; Amee M Shah; Alexandra Channing; Jamie K Harrington; Thomas J Connors; Karen Martirosyan; Usha S Krishnan; Anne Ferris; Rachel J Weller; Donna L Farber; Joshua D Milner; Mark Gorelik; Erika B Rosenzweig; Brett R Anderson Journal: Res Sq Date: 2022-01-24
Authors: Camilla Astley; Maria Fernanda Badue Pereira; Marcos Santos Lima; Carlos Alberto Buchpiguel; Camila G Carneiro; Marcelo Tatit Sapienza; Gabriela Nunes Leal; Danilo Marcelo Leite do Prado; Tiago Peçanha; Sofia Mendes Sieczkowska; Olivia Mari Matsuo; Livia Lindoso; Heloisa Helena Marques; Clovis Artur Silva; Bruno Gualano Journal: Physiol Rep Date: 2022-03