Cardiovascular complications of COVID-associated multisystem inflammatory syndrome in an infant: A case report

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Abstract

Multisystem inflammatory syndrome is an extremely severe form of coronavirus infection in children, which characterized by systemic hyperinflammation with multiple organ failure. In some cases, cardiovascular complications are reported, including myocardial dysfunction, myocardial ischemia, shock, arrhythmias, coronaritis and coronary artery aneurysms. Although the incidence of coronavirus infection has decreased, patient mortality from multisystem inflammatory syndrome remains high. A clinical case of COVID-associated multisystem inflammatory syndrome in an infant is presented. Since admission, the patient with a high titer of immunoglobulin G with SARS-CoV-2 showed signs of hyperinflammation with subsequent development of pericarditis and myocardial dysfunction associated with prolonged bilateral pneumonia. Coronaritis and aneurysm of the left coronary artery were diagnosed. The patient had a long history of reduced global contractile function and high levels of myocardial damage markers requiring prolonged inotropic support and use of cardiac glycosides. Later, paroxysmal tachycardia developed in addition to cardiovascular complications. Comprehensive management of the disease and early detection of complications resulted in a favorable outcome.

About the authors

Artyom Yu. Smykov

Regional Children’s Clinical Hospital

Author for correspondence.
Email: smykov.artjom@yandex.ru
ORCID iD: 0009-0002-1385-8244
SPIN-code: 4827-9696
Russian Federation, Rostov-on-Don

Fedor G. Sharshov

Regional Children’s Clinical Hospital

Email: odb_orit@mail.ru
ORCID iD: 0000-0002-2540-5640
SPIN-code: 8572-1020

MD, Dr. Sci. (Medicine), Assistant Professor

Russian Federation, Rostov-on-Don

Ivan F. Ostreikov

Russian Medical Academy of Continuous Professional Education

Email: ifo_41@mail.ru
ORCID iD: 0000-0002-4863-1958

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Sergey E. Khoroshilov

Main Military Clinical Hospital named after Academician N.N. Burdenko

Email: intensive@list.ru
ORCID iD: 0000-0002-0427-8099
SPIN-code: 7071-6642

MD, Dr. Sci. (Medicine)

Russian Federation, Moscow

Victor V. Moroz

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

Email: fnkcrr@fnkcrr.ru
ORCID iD: 0000-0002-8880-7364
SPIN-code: 5152-6626

MD, Dr. Sci. (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences

Russian Federation, Moscow

Igor V. Molchanov

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

Email: igormo146@mail.ru
ORCID iD: 0000-0003-4252-2387
SPIN-code: 8315-2530

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

Elena A. Spiridonova

Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology

Email: Elena.Spiridonova@fccho-moscow.ru
ORCID iD: 0000-0002-5230-5725
SPIN-code: 1729-8002

MD, Dr. Sci. (Medicine), Professor

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. Echocardiogram showing free fluid in the pericardial cavity (17 mm)

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3. Fig. 2. Echocardiogram showing dilation of the left and right coronary arteries

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4. Fig. 3. Electrocardiography findings indicating myocardial ischemia in the child

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5. Fig. 4. Reduced left ventricular ejection fraction and ventricular septal hypokinesia

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6. Fig. 5. Aneurysm of the left coronary artery

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