Written by Kimiko Dunbar
Spoon Feed
Over 90% of patients with MIS-C have a full recovery by 6 months after hospital discharge, including normalization of cardiovascular complications.
Time heals all wounds
This cohort study assessed cardiac and noncardiac outcomes in 1,204 children diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C) after COVID-19. The study included 32 North American hospitals and followed patients from hospitalization to six months post-discharge. In contrast to patients with Kawasaki disease, 40.8% of participants had depressed left ventricular function on presentation; 99% normalized by 6 months. 4.4% of patients had a LAD or RCA z-score of 2.5 or more during hospitalization; of those, 92.3% had resolved coronary artery abnormalities. 95.1% reported returning to >90% baseline health, including energy level, sleep, mood, appetite and cognition. Importantly, due to funding constraints, only 28.9% of echos were reviewed by the study, significantly limiting the sample size. Priority was given to patients who had serial echos performed through 6 months, which may have created sampling bias.
How will this change my practice?
The prevalence of MIS-C has gone down significantly, so much so that I can’t remember treating a patient with MIS-C in the last year or even two. That said, patients with MIS-C tended to be sick, often with hemodynamic instability requiring critical care. At the time when we were treating a lot of MIS-C, we didn’t have great data on long-term outcomes and couldn’t answer parent questions. If we see another wave of MIS-C, this study will change the way I talk to patients and their families and my confidence in providing reassurance.
Source
Six-Month Outcomes in the Long-Term Outcomes After the Multisystem Inflammatory Syndrome in Children Study. JAMA Pediatr. 2025 Mar 1;179(3):293-301. doi: 10.1001/jamapediatrics.2024.5466. PMID: 39804656
