Repercusiones cardiovasculares derivadas del Síndrome Inflamatorio Multisistémico posterior a la infección por COVID-19 en la edad pediátrica: una revisión integradora

Autores/as

DOI:

https://doi.org/10.33448/rsd-v11i5.28776

Palabras clave:

Síndrome Multisistémico Inflamatorio; Pediatría; COVID-19; Cardiología; Enseñanza.

Resumen

La población pediátrica constituye solo el 2% de los casos de COVID-19, sin embargo, se han reportado casos de shock inflamatorio, disfunción ventricular y eventos trombóticos. Este conjunto de signos se denomina Síndrome Inflamatorio Multisistémico (MIS-C), caracterizado también por hiperpirexia y falla orgánica generalizada, con relación directa con la infección por SARS-COV-2. El presente trabajo tiene como objetivo sintetizar la evidencia de las manifestaciones cardiovasculares derivadas del Síndrome Inflamatorio Multisistémico Post COVID-19 en la edad pediátrica (PMIS-TS). Para esta Revisión Integradora, realizada a través de las plataformas PubMed y Science Direct entre 2020 y 2022, los descriptores elegidos fueron ''Inflamación'', ''Pediatría'', ''Covid-19'' y ''Cardiología'', asociados al operador booleano ''Y''. Los criterios de inclusión consistieron en (1) ensayos clínicos, ensayos controlados y aleatorizados, revisiones y metanálisis; (2) estudios sobre las repercusiones cardiovasculares del PMIS-TS; (3) estudios sobre miocardiopatías pediátricas derivadas de la infección por coronavirus; (4) artículos sobre gestión y tratamiento de PMIS-TS. Los criterios de exclusión incluyeron insuficiencias al tema, evaluaciones de otras condiciones clínicas, además de textos no específicos al abordar MIS-C. Se observó que los casos de PMIS-TS tenían ecocardiogramas y resonancia magnética predictivos de miocarditis, valvulitis y enfermedad coronaria, hallazgos corroborados por alteraciones de laboratorio. Los electrocardiogramas incluyeron latidos prematuros y varias arritmias. En el análisis de los 54 artículos, se identificó que, a pesar de que el grupo de edad pediátrica corresponde a la menor proporción de casos de COVID-19, los niños son susceptibles a repercusiones potencialmente graves. Por lo tanto, el estado hiperinflamatorio puede conducir a la muerte, y es fundamental realizar nuevos estudios con opciones terapéuticas asertivas para las condiciones mencionadas.

Citas

Alcindor, M. L., Alcindor, F., Richard, K. E., Ajay, G., Denis, A. M., Dickson, D. M., & Allen, D. (2021). COVID-19 Management in Pediatrics. JNP., 17(5), 528-535.

Alsaied, T., Tremoulet, A. H., Burns, J. C., Saidi, A., Dionne, A., Lang, S. M., & Friedman, K. G. (2021). Review of cardiac involvement in multisystem inflammatory syndrome in children. Circulation, 143(1), 78-88.

Barach, P., & Lipshultz, S. E. (2020). Rethinking COVID-19 in children: lessons learned from pediatric viral and inflammatory cardiovascular diseases. PPC, 57, 101233.

Blatz, A., & Randolph, A. (2022). Severe COVID-19 and MIS-C In Children & Adolescents. Crit Care Clin.

Bogiatzopoulou, A., Mayberry, H., Hawcutt, D. B., Whittaker, E., Munro, A., Roland, D., & Harwood, R. (2020). COVID-19 in children: what did we learn from the first wave?. PCH, 30(12), 438-443.

Bucciarelli, V., Nasi, M., Bianco, F., Seferovic, J., Ivkovic, V., Gallina, S., & Mattioli, A. V. (2021). Depression pandemic and cardiovascular risk in the COVID-19 era and long COVID syndrome: gender makes a difference. Trends Cardiovasc. Med.

Case, S. M., & Son, M. B. (2021). COVID-19 in Pediatrics. Rheum Dis Clin North Am., 47(4), 797-811.

da Paz Silva Filho, P. S., Osternes, F. N. D., Balsamo, A. C. M., Kirchesch, C. L., da Cruz, E. S., Santos, T. C. S., & da Silva Caetano, V. (2020). Insuficiência cardíaca relacionada a infecção por COVID-19: com ênfase em idosos. RSD, 9(9), e397997307-e397997307.

DeBiasi, R. L., Harahsheh, A. S., Srinivasalu, H., Krishnan, A., Sharron, M. P., Parikh, K., & Bard, J. D. (2021). Multisystem inflammatory syndrome of children: subphenotypes, risk factors, biomarkers, cytokine profiles, and viral sequencing. J Pediat., 237, 125-135.

Dionne, A., Son, M. B. F., & Randolph, A. G. (2022). An Update on Multisystem Inflammatory Syndrome in Children Related to SARS-CoV-2. PIDJ., 41(1), e6.

dos Santos, L. E. S., & dos Santos, L. S. (2021). O impacto do coronavírus em pacientes cardiopatas. RSD, 10(5), e0110514539-e0110514539.

Dufort, E. M., Koumans, E. H., Chow, E. J., Rosenthal, E. M., Muse, A., Rowlands, J., & Zucker, H. (2020). Multisystem inflammatory syndrome in children in New York State. NEJM., 383(4), 347-358.

Edwards, J. J., Harris, M. A., Toib, A., Burstein, D. S., & Rossano, J. W. (2022). Asymmetric septal edema masking as hypertrophy in an infant with COVID-19 myocarditis. PPC, 64, 101464.

El-Assaad, I., Hood-Pishchany, M. I., Kheir, J., Mistry, K., Dixit, A., Halyabar, O., & Cheng, H. (2020). Complete heart block, severe ventricular dysfunction, and myocardial inflammation in a child with COVID-19 infection. JACC: Case Reportsms, 2(9), 1351-1355.

Elias, M. D., McCrindle, B. W., Larios, G., Choueiter, N. F., Dahdah, N., Harahsheh, A. S., & Dionne, A. (2020). Management of multisystem inflammatory syndrome in children associated with COVID-19: a survey from the International Kawasaki Disease Registry. Cjc Open, 2(6), 632-640.

Emeksiz, S., Çelikel Acar, B., Kibar, A. E., Özkaya Parlakay, A., Perk, O., Bayhan, G. İ., & Şenel, E. (2021). Algorithm for the diagnosis and management of the multisystem inflammatory syndrome in children associated with COVID‐19. Int J Clin Pract., 75(9), e14471.

Evans, C., & Davies, P. (2021). SARS-CoV-2 paediatric inflammatory syndrome. PCH, 31(3), 110-115.

Felsenstein, S., Duong, P., Lane, S., Jones, C., Pain, C. E., & Hedrich, C. M. (2021). Cardiac pathology and outcomes vary between Kawasaki disease and PIMS-TS. Clin. Immunol., 229, 108780.

Fialkowski, A., Gernez, Y., Arya, P., Weinacht, K. G., Kinane, T. B., & Yonker, L. M. (2020). Insight into the pediatric and adult dichotomy of COVID‐19: age‐related differences in the immune response to SARS‐CoV‐2 infection. Pediatr. Pulmonol., 55(10), 2556-2564.

Friedman, K. G., Harrild, D. M., & Newburger, J. W. (2020). Cardiac dysfunction in multisystem inflammatory syndrome in children: a call to action. JAACC, 76(17), 1962-1964.

Geva, A., Patel, M. M., Newhams, M. M., Young, C. C., Son, M. B. F., Kong, M., & Overcoming COVID-19 Investigators. (2021). Data-driven clustering identifies features distinguishing multisystem inflammatory syndrome from acute COVID-19 in children and adolescents. eClinicalMedicine., 40, 101112.

Güllü, U. U., Güngör, Ş., İpek, S., Yurttutan, S., & Dilber, C. (2021). Predictive value of cardiac markers in the prognosis of COVID-19 in children. The Am J Emerg Med., 48, 307-311.

Harwood, R., Allin, B., Jones, C. E., Whittaker, E., Ramnarayan, P., Ramanan, A. V., & Yardley, I. (2021). A national consensus management pathway for paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS): results of a national Delphi process. Lancet Child Adolesc. Health.., 5(2), 133-141.

Hejazi, O. I., Loke, Y. H., & Harahsheh, A. S. (2021). Short-term Cardiovascular Complications of Multi-system Inflammatory Syndrome in Children (MIS-C) in Adolescents and Children. Curr. Pediatr. Rep., 9(4), 93-103.

Hennon, T. R., Karl, O. A., Penque, M. D., Abdul-Aziz, R., Chang, A. C., McGreevy, M. B., & Hicar, M. D. (2021). COVID-19 associated Multisystem Inflammatory Syndrome in Children (MIS-C) guidelines; revisiting the Western New York approach as the pandemic evolves. PPC, 62, 101407.

Holstein, B. (2021). Multisystem Inflammatory Syndrome in Children. JNP, 17(8), 941-945.

Imazio, M., Klingel, K., Kindermann, I., Brucato, A., De Rosa, F. G., Adler, Y., & De Ferrari, G. M. (2020). COVID-19 pandemic and troponin: indirect myocardial injury, myocardial inflammation or myocarditis?. Heart, 106(15), 1127-1131.

Jain, S., Nolan, S. M., Singh, A. R., Lovig, L., Biller, R., Kamat, A., & Gewitz, M. H. (2020). Myocarditis in multisystem inflammatory syndrome in children associated with coronavirus disease 2019. Cardiol Rev., 28(6), 308-311.

Jiang, L., Tang, K., Levin, M., Irfan, O., Morris, S. K., Wilson, K., & Bhutta, Z. A. (2020). COVID-19 and multisystem inflammatory syndrome in children and adolescents. Lancet Infect. Dis. Journal, 20(11), e276-e288.

Kaushik, S., Aydin, S. I., Derespina, K. R., Bansal, P. B., Kowalsky, S., Trachtman, R., & Medar, S. S. (2020). Multisystem inflammatory syndrome in children associated with severe acute respiratory syndrome coronavirus 2 infection (MIS-C): a multi-institutional study from New York City. J Pediatr, 224, 24-29.

Kiss, A., Ryan, P. M., & Mondal, T. (2021). Management of COVID-19-associated multisystem inflammatory syndrome in children: A comprehensive literature review. PPC, 63, 101381.

Kline, J. N., Isbey, S. C., McCollum, N. L., Falk, M. J., Gutierrez, C. E., Guse, S. E., & Breslin, K. A. (2022). Identifying pediatric patients with multisystem inflammatory syndrome in children presenting to a pediatric emergency department. Am J Emerg Med.., 51, 69-75.

Kobayashi, R., Dionne, A., Ferraro, A., Harrild, D., Newburger, J., VanderPluym, C., & Friedman, K. G. (2021). Detailed Assessment of Left Ventricular Function in Multisystem Inflammatory Syndrome in Children, Using Strain Analysis. CJC open, 3(7), 880-887.

Kohli, U., Meinert, E., Chong, G., Tesher, M., & Jani, P. (2020). Fulminant myocarditis and atrial fibrillation in child with acute COVID-19. J Electrocardiol.

Lamrani, L., Manlhiot, C., Elias, M. D., Choueiter, N. F., Dionne, A., Harahsheh, A. S., & Dahdah, N. (2021). Kawasaki Disease Shock Syndrome vs Classical Kawasaki Disease: A Meta-analysis and Comparison With SARS-CoV-2 Multisystem Inflammatory Syndrome. CJC, 37(10), 1619-1628.

Loke, Y. H., Berul, C. I., & Harahsheh, A. S. (2020). Multisystem inflammatory syndrome in children: is there a linkage to Kawasaki disease?. Trends Cardiovasc. Med., 30(7), 389-396.

Loomba, R. S., Villarreal, E. G., & Flores, S. (2020). COVID-19 and hyperinflammatory syndrome in children: Kawasaki disease with macrophage activation syndrome in disguise?. Curēus, 12(8).

Malviya, A., & Mishra, A. (2021). Childhood multisystem inflammatory syndrome: an emerging disease with prominent cardiovascular involvement—a scoping review. SN Compr Clin Med., 3(1), 48-59.

Marino, A., Varisco, T., Quattrocchi, G., Amoroso, A., Beltrami, D., Venturiello, S., & Cimaz, R. (2021). Children with Kawasaki disease or Kawasaki-like syndrome (MIS-C/PIMS) at the time of COVID-19: are they all the same? Case series and literature review. Reumatismo, 73(1), 48-53.

Matsubara, D., Kauffman, H. L., Wang, Y., Calderon-Anyosa, R., Nadaraj, S., Elias, M. D., & Banerjee, A. (2020). Echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 in the United States. JACC, 76(17), 1947-1961.

Niaz, T., Hope, K., Fremed, M., Misra, N., Altman, C., Glickstein, J., & Chowdhury, D. (2021). Role of a pediatric cardiologist in the COVID-19 pandemic. Pediatr Cardiol, 42(1), 19-35.

Prata-Barbosa, A., Lima-Setta, F., Santos, G. R. D., Lanziotti, V. S., Castro, R. E. V. D., Souza, D. C. D., & Magalhães-Barbosa, M. C. D. (2020). Pediatric patients with COVID-19 admitted to intensive care units in Brazil: a prospective multicenter study. J Pediatr (Rio J), 96, 582-592.

Penner, J., Abdel-Mannan, O., Grant, K., Maillard, S., Kucera, F., Hassell, J., & Papadopoulou, C. (2021). 6-month multidisciplinary follow-up and outcomes of patients with paediatric inflammatory multisystem syndrome (PIMS-TS) at a UK tertiary paediatric hospital: a retrospective cohort study. Lancet Child Adolesc. Health, 5(7), 473-482.

Petersen, S. E., Friedrich, M. G., Leiner, T., Elias, M. D., Ferreira, V. M., Fenski, M., & Bluemke, D. A. (2021). Cardiovascular magnetic resonance for patients with COVID-19. JACC: Cardiovascular Imaging.

Regan, W., O’Byrne, L., Stewart, K., Miller, O., Pushparajah, K., Theocharis, P., & Rosenthal, E. (2021). Electrocardiographic changes in children with multisystem inflammation associated with COVID-19: associated with coronavirus disease 2019. J Pediatr, 234, 27-32.

Rimensberger, P. C., Kneyber, M. C., Deep, A., Bansal, M., Hoskote, A., Javouhey, E., & Brierley, J. (2021). Caring for critically ill children with suspected or proven coronavirus disease 2019 infection: recommendations by The Scientific Sections’ Collaborative of The European Society of Pediatric and Neonatal

Intensive Care. PCCM, 22(1), 56.

Sanil, Y., Misra, A., Safa, R., Blake, J. M., Eddine, A. C., Balakrishnan, P., & Singh, G. (2021). Echocardiographic indicators associated with adverse clinical course and cardiac sequelae in multisystem inflammatory syndrome in children with coronavirus disease 2019. JASE, 34(8), 862-876.

Sharma, C., Ganigara, M., Galeotti, C., Burns, J., Berganza, F. M., Hayes, D. A., & Bayry, J. (2021). Multisystem inflammatory syndrome in children and Kawasaki disease: a critical comparison. Nat. rev., Rheumatol., 17(12), 731-748.

Simpson, M., Collins, C., Nash, D. B., Panesar, L. E., & Oster, M. E. (2020). Coronavirus disease 2019 infection in children with pre-existing heart disease. J Pediat, 227, 302-307.

Sperotto, F., Friedman, K. G., Son, M. B. F., VanderPluym, C. J., Newburger, J. W., & Dionne, A. (2021). Cardiac manifestations in SARS-CoV-2-associated multisystem inflammatory syndrome in children: a comprehensive review and proposed clinical approach. EJPE, 180(2), 307-322.

Thrift, K. C., Withycombe, J. S., & Temples, H. S. (2021). Is it Kawasaki Disease or Multisystem Inflammatory Syndrome in Children?. JNP, 17(10), 1230-1236.

Torres, J. P., Izquierdo, G., Acuña, M., Pavez, D., Reyes, F., Fritis, A., & Tapia, L. I. (2020). Multisystem inflammatory syndrome in children (MIS-C): Report of the clinical and epidemiological characteristics of cases in Santiago de Chile during the SARS-CoV-2 pandemic. IJID, 100, 75-81.

Truong, D. T., Trachtenberg, F. L., Pearson, G. D., Dionne, A., Elias, M. D., Friedman, K., & Chrisant, M. (2022). The NHLBI Study on Long-terM OUtcomes after the Multisystem Inflammatory Syndrome In Children (MUSIC): Design and Objectives. Am. heart j., 243, 43-53.

Vari, D., Miller, J. M., Rellosa, N., Srivastava, S., Frizzola, M., & Thacker, D. (2020). Severe cardiac dysfunction in a patient with multisystem inflammatory syndrome in children associated with COVID-19: Retrospective diagnosis of a puzzling presentation. A case report. PPC, 58, 101270.

Vogel, T. P., Top, K. A., Karatzios, C., Hilmers, D. C., Tapia, L. I., Moceri, P., & Munoz, F. M. (2021). Multisystem inflammatory syndrome in children and adults (MIS-C/A): Case definition & guidelines for data collection, analysis, and presentation of immunization safety data. Vaccine, 39(22), 3037-3049.

Wu, E. Y., & Campbell, M. J. (2021). Cardiac Manifestations of Multisystem Inflammatory Syndrome in Children (MIS-C) Following COVID-19. Current Science, 23(11), 1-9.

Zhou, C., Zhao, Y., Wang, X., Huang, Y., Tang, X., & Tang, L. (2021). Laboratory parameters between multisystem inflammatory syndrome in children and Kawasaki disease. Pediatric Pulmonology, 56(12), 3688-3698.

Publicado

16/04/2022

Cómo citar

SANTOS, T. L. .; LIMA, C. S. de A. .; FREITAS, C. M. de .; MARINHO, A. D. .; PARREIRA, W. da S. P. .; NASCIMENTO , B. K. C. .; LIMA, A. S. .; VIEIRA, J. T. .; BORGES , A. D. .; TOQUETON, T. R. .; MOREIRA, L. L. .; OLIVEIRA, M. F. de . Repercusiones cardiovasculares derivadas del Síndrome Inflamatorio Multisistémico posterior a la infección por COVID-19 en la edad pediátrica: una revisión integradora. Research, Society and Development, [S. l.], v. 11, n. 5, p. e56211528776, 2022. DOI: 10.33448/rsd-v11i5.28776. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/28776. Acesso em: 31 jul. 2024.

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