| Abstrakt: |
Symptoms of acute Covid-19 infection are less common in children than in adults. In most cases, the symptoms are mild or absent. However, after contact with SARS-CoV-2, children may develop post-infectious hyperinflammatory syndrome - multisystem inflammatory syndrome in children (Multisystem Inflammatory Syndrome in Children MIS-C). We present 6 children with MIS-C, observed in November and December 2020 during the peak incidence of Covid-19 infection in Bulgaria. Patients have a mean age of 9.7 years. Four of the children had a history of contact with Covid-19. Clinically, they presented with fever and gastrointestinal symptoms. SARSCoV2 IgM and IgG serology was positive in all patients. Troponin and pro-BNP (B-type natriuretic peptide) levels were elevated in all six children. Cardiac ultrasound revealed systolic dysfunction of the left ventricle (reduce ejection fraction) in all of them. When cardiac MRI was performed, limited areas of left ventricular myocardial edema, as well as areas of late non-ischemic gadolinium amplification involving up to 25% of the myocardium, were founded. Treatment in all patients includes a broad-spectrum antibiotic, intravenous immunoglobulin, corticosteroids, diuretic, ACE inhibitor, and low molecular weight heparin. At discharge, all patients were in good overall condition, with no signs of heart failure, normal echocardiographic findings, and laboratory tests. In children the mortality from MIS-C is not high, despite significant increase in inflammatory markers and multisystem symptoms. In our patients, the short term outcome of MIS-C is favorable. However, long-term follow-up is needed for late complications. [ABSTRACT FROM AUTHOR] |
