Multisystem Inflammatory Syndrome Cardiovascular Complications in Patient associated with SARS-CoV-2 Infection

Abstract

Cases of long-term outcomes of a novel disease MIS-C have rarely been reported. The most common cardiac manifestations of MIS-C are myocarditis, coronary artery aneurysms, conduction abnormalities, and arrhythmias. We report a case of an 8-year-old boy, who has Asperger syndrome, with a complicated course of disease called MIS-C during Covid-19 outbreak, when this was the first diagnosis of MIS-C in Latvia. The patient was tested positive for the SARS-CoV-2 (RNA) and Hemophilus influenza (DNA). In 9th day of hospitalization, the diagnosis of MIS-C was performed. He had involvement of gastrointestinal, cardiovascular, respiratory and coagulation systems. The patient received therapy with IVIG, Anakinra as well antibiotics and cardiovascular medicine. During hospitalisation patient had complications such as anemia of a combined nature, post-infectious bone marrow suppression, hepatosplenomegaly and candidiasis due to CVC. The cardiac magnetic resonance imaging (cMRI) after being diagnosed with MIS-C revealed edema and focal changes in LV inferior wall, although volume of both ventricles and LV systolic function were normal. A year after the follow-up cMRI, showed resolution of the myocardial edema. In existing literature there are several cohort studies about long-term outcome of MIS-C myocarditis in 6 month follow-up visit, showing no evidence of scar tissues in cMRI, but in some patients- diastolic dysfunction was detected. This report emphasizes a complicated form of disease in patient who has Asperger syndrome with excellent outcome.