Publication date: Jul 16, 2024
Background: Multisystem Inflammatory Syndrome in Children (MIS-C) has emerged as a severe pediatric complication during the SARS-CoV-2 pandemic, with potential long-term cardiovascular repercussions. We hypothesized that heart rate and blood pressure control at rest and during postural maneuvers in MIS-C patients, months after the remission of the inflammatory syndrome, may reveal long-term autonomic dysfunctions. Methods: We assessed 17 MIS-C patients (13 males; 11. 9 +/- 2. 6 years, m +/- SD) 9 months after acute infection and 18 age- (12. 5 +/- 2. 1 years) and sex- (13 males) matched controls. Heart rate and blood pressure variability, baroreflex function, and hemodynamic parameters were analyzed in supine and standing postures. Results: MIS-C patients exhibited reduced heart rate variability, particularly in parasympathetic parameters during standing (pNN50+: 6. 1 +/- 6. 4% in controls, 2. 5 +/- 3. 9% in MIS-C; RMSSD: 34 +/- 19 ms in controls, 21 +/- 14 ms in MIS-C, p < 0. 05), with no interaction between case and posture. Blood pressure variability and baroreflex sensitivity did not differ between groups except for the high-frequency power in systolic blood pressure (3. 3 +/- 1. 2 mmHg in controls, 1. 8 +/- 1. 2 mmHg in MIS-C, p < 0. 05). The MIS-C group also showed lower diastolic pressure-time indices (DPTI) and systolic pressure-time indices (SPTI), particularly in standing (DPTI: 36. 2 +/- 9. 4 mmHg.s in controls, 29. 4 +/- 6. 2 mmHg.s in MIS-C; SPTI: 26. 5 +/- 4. 3 mmHg.s in controls, 23. 9 +/- 2. 4 mmHg.s in MIS-C, p < 0. 05). Conclusions: Altered cardiovascular autonomic control may persist in MIS-C patients with, however, compensatory mechanisms that may help maintain cardiovascular homeostasis during light autonomic challenges, such as postural maneuvers. These results highlight the importance of assessing long-term cardiovascular autonomic control in children with MIS-C to possibly identify residual cardiovascular risks and inform targeted interventions and rehabilitation protocols.
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| Concepts | Keywords |
|---|---|
| Covid | adolescent |
| Hemodynamic | autonomic nervous system |
| Males | baroreflex sensitivity |
| Months | heart rate variability |
| Pandemic | MIS-C |
| pediatric |
Semantics
| Type | Source | Name |
|---|---|---|
| disease | MESH | COVID-19 |
| disease | MESH | Multisystem Inflammatory Syndrome in Children |
| pathway | REACTOME | SARS-CoV-2 Infection |
| disease | IDO | blood |
| disease | MESH | syndrome |
| disease | IDO | acute infection |
| disease | MESH | postures |
| disease | VO | frequency |
| disease | VO | time |
| disease | MESH | Vascular Diseases |
| drug | DRUGBANK | Coenzyme M |
| disease | MESH | shock |
| disease | IDO | intervention |
| disease | MESH | sequelae |
| disease | MESH | infection |
| disease | MESH | Kawasaki disease |
| disease | IDO | history |
| disease | VO | population |
| disease | VO | protocol |
| disease | IDO | algorithm |
| disease | MESH | premature beats |
| drug | DRUGBANK | Isoxaflutole |
| disease | VO | effectiveness |
| disease | MESH | ventricular pressure |
| drug | DRUGBANK | Oxygen |
| disease | MESH | stroke |
| disease | VO | volume |
| disease | VO | ANOVA |
| disease | VO | USA |
| disease | MESH | orthostatic hypotension |
| drug | DRUGBANK | Lysergic acid diethylamide |