Objective: To investigate cardiac manifestations, treatment characteristics, and outcomes of paediatric inflammatory multisystem syndrome (PIMS) temporally associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) (PIMS-TS).
Method: We performed a comprehensive literature search of several databases and qualitatively synthesized findings from studies .
Results: Twenty-six studies were included with 1228 pooled subjects, with a mean age of 8.6 years, which were dominated by male gender (53 %), and African ethnicity (31 %). 732 (38 %) patients were reactive on a serological test, and 457 patients (45 %) were positive on SARS-CoV-2 RT-PCR . ST-segment abnormalities were the most common ECG findings (16%, n/N : 34/212). Various markers of troponin and the pooled mean of BNP and NT-pro-BNP levels were elevated . Cardiomegaly and pericardial effusion (21.8%, n/N : 164/751) was the most common chest X-ray findings . In echocardiography, the majority of patients' left ventricular ejection fraction was reduced (59.0%, n/N : 180/305), with pericardial effusion/ pericarditis seen the most (17.44%, n/N : 221/1267), and Z score ≥ 2 in 28% (n/N : 42/139). Cardiac MRI findings were consistent with acute myocarditis . Intravenous immunoglobulin, corticosteroids, and vasoactive drugs were frequently utilized . The mean length of stay was 6 days, with most patients (71%, n/N : 834/1163) were admitted to the ICU . However, the overall prognosis was favourable, with 98% alive (n/N : 1235/1260), and more than 50% of patients experienced recovery of left ventricular systolic functions at discharge (116 out of 206 patients). Conclusion: PIMS-TS is a rare clinical syndrome associated with a multiorgan system dysfunction, especially acute cardiac injury, and mandates a higher level of care.Nevertheless, when appropriate treatments are available, the cardiac function rapidly reverted to normal in most cases, and it was associated with a favourable outcome in general . Of concern, medium and long-term prognosis remains to be elucidated.
Index: COVID-19, Kawasaki, PIMS-TS, SARS-CoV-2, Toxic Shock Syndrome