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Misra et al. Vessel Plus 2022;6:14 Vessel Plus
DOI: 10.20517/2574-1209.2021.89

Review Open Access

Cardiovascular involvement in multisystem

inflammatory syndrome in children with COVID-19

1
1
1
1
Amrit Misra , Raya Safa 1,2,3 , Yamuna Sanil , Jennifer M. Blake , Ahmad Charaf Eddine , Preetha
1
1,3
Balakrishnan , Richard U. Garcia 1,2,3 , Sanjeev Aggarwal , Gautam Singh 1
1
Department of Pediatrics, Division of Pediatric Cardiology, Central Michigan University College of Medicine, Children’s Hospital
of Michigan, Detroit, MI 48201, USA.
2
Department of Pediatrics, Division of Pediatric Critical Care Medicine, Central Michigan University College of Medicine,
Children’s Hospital of Michigan, Detroit, MI 48201, USA.
3
Department of Pediatrics, Division of Pediatric Cardiology, Wayne State University School of Medicine, Children’s Hospital of
Michigan, Detroit, MI 48201, USA.
Correspondence to: Gautam Singh, MD, Division of Pediatric Cardiology, Children’s Hospital of Michigan, Central Michigan
University College of Medicine, 3901 Beaubien Blvd, Detroit, MI 48201, USA. E-mail: Gsingh3@dmc.org
How to cite this article: Misra A, Safa R, Sanil Y, Blake JM, Charaf Eddine A, Balakrishnan P, Garcia RU, Aggarwal S, Singh G.
Cardiovascular involvement in multisystem inflammatory syndrome in children with COVID-19. Vessel Plus 2022;6:14.
https://dx.doi.org/10.20517/2574-1209.2021.89
Received: 30 Jun 2021 First Decision: 4 Aug 2021 Revised: 18 Aug 2021 Accepted: 1 Sep 2021 Published: 5 Mar 2022

Academic Editors: Alexander D. Verin, Frank W. Sellke, P. Syamasundar Rao Copy Editor: Xi-Jun Chen Production Editor: Xi-
Jun Chen

Abstract
In children, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections typically result in a less
severe coronavirus 19 (COVID-19) presentation than in adults. However, a subset of children presents with severe
multisystem inflammation associated with recent SARS-CoV-2 infection or COVID-19 exposure in the previous
weeks. The Center for Disease Control (CDC) has termed this condition a multisystem inflammatory syndrome in
children (MIS-C). MIS-C causes significant cardiovascular involvement, which can be a determinant of clinical
course and outcomes. A subset of MIS-C patients presents with hypotension and shock either from acute
myocardial dysfunction or systemic vasodilation, with at least of third of patients developing cardiac manifestations
from the illness. In addition, myocarditis, pericarditis, valvular regurgitation, coronary artery involvement, and
arrhythmias have been reported, with a smaller subset of patients requiring extracorporeal membrane oxygenation.
Here, we report our institutional experience of MIS-C over the last year and present a narrative review of cases
reported in the literature. In addition, we discuss the clinical protocol of diagnosis and acute and follow-up
management of these patients with MIS-C.

© The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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