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Background: Cardiac injury and myocarditis have been described in adults with coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children is typically minimally symptomatic. We report a series of febrile pediatric patients with acute heart failure potentially associated with SARS-CoV-2 infection and the multisystem inflammatory syndrome in children as defined by the US Centers for Disease Control and Prevention. Methods: Over a 2-month period, contemporary with the SARS-CoV-2 pandemic in France and Switzerland, we retrospectively collected clinical, biological, therapeutic, and early outcomes data in children who were admitted to pediatric intensive care units in 14 centers for cardiogenic shock, left ventricular dysfunction, and severe inflammatory state. Results: Thirty-five children were identified and included in the study. Median age at admission was 10 years (range, 2–16 years). Comorbidities were present in 28%, including asthma and overweight. Gastrointestinal symptoms were prominent. Left ventricular ejection fraction was Conclusions: Children may experience an acute cardiac decompensation caused by severe inflammatory state after SARS-CoV-2 infection (multisystem inflammatory syndrome in children). Treatment with immunoglobulin appears to be associated with recovery of left ventricular systolic function.

p. 269-274 Submitted by Suelen Reis (suziy.ellen@gmail.com) on 2013-10-15T14:58:13Z No. of bitstreams: 1 en_v92n4a06.pdf: 369689 bytes, checksum: f38dcddfd847d43f6c3ebf3c72ba504e (MD5) Approved for entry into archive by Rodrigo Meirelles (rodrigomei@ufba.br) on 2013-11-18T21:13:02Z (GMT) No. of bitstreams: 1 en_v92n4a06.pdf: 369689 bytes, checksum: f38dcddfd847d43f6c3ebf3c72ba504e (MD5) Made available in DSpace on 2013-11-18T21:13:02Z (GMT). No. of bitstreams: 1 en_v92n4a06.pdf: 369689 bytes, checksum: f38dcddfd847d43f6c3ebf3c72ba504e (MD5) Previous issue date: 2009 Background: Studies comparing inflammatory activity between diabetic and non diabetic individuals with acute coronary syndrome are scarce, and none including only patients with unstable angina (UA) has been published to date. Objective: We compared serum C-reactive protein (CRP), and interleukin-6(IL-6) between diabetic and non-diabetic patients with unstable angina (UA) to determine if difference in inflammatory activity is responsible for a worse prognosis in diabetic patients. We also evaluated the correlation between inflammatory markers and the metabolic profile in diabetic patients and the correlation between inflammatory response and in-hospital outcomes: death, acute myocardial infarction, congestive heart failure, and length of stay in hospital. Methods: A prospective cohort study of 90 consecutive patients admitted to a chest pain unit with UA and divided into two groups, diabetic and non-diabetic. Serum CRP, IL-6, metabolic profile and leukocyte count were measured at hospital arrival. Results: Forty-two patients (47%) were diabetic (age 62±9) vs. 48 (53%) non diabetic (age 63±12). No differences between median C-reactive protein (1.78 vs. 2.23mg/l,p=0.74) and interleukin-6 (0 vs. 0pg/ml,p=0.31) were found between the two groups. There was a positive correlation between CRP and total cholesterol (rs = 0.21,p = 0.05), CRP and LDL-cholesterol (rs=0.22,p=0.04) and between CRP and leukocyte count (rs = 0.32, p = 0.02) in both groups. No associations were found between inflammatory markers and in-hospital outcomes. Conclusion: We found no difference in inflammatory activity between diabetic and non diabetic patients with UA, suggesting that this clinical condition may result in balanced inflammatory activity between the two groups and increase acute-phase proteins independently of metabolic state.