Multicentre observational study on multisystem inflammatory syndrome related to COVID-19 in Argentina.

BACKGROUND: The impact of the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) in low- and middle-income countries remains poorly understood. Our aim was to understand the characteristics and outcomes of PIMS-TS in Argentina. METHODS: This observational, prospective, and retrospective multicenter study enrolled patients younger than 18 years-old manifesting PIMS-TS, Kawasaki disease (KD) or Kawasaki shock syndrome (KSS) between March 2020 and May 2021. Patients were followed-up until hospital discharge or death (one case). The primary outcome was pediatric intensive care unit (PICU) admission. Multiple logistic regression was used to identify variables predicting PICU admission. RESULTS: Eighty-one percent, 82%, and 14% of the 176 enrolled patients fulfilled the suspect case criteria for PIMS-TS, KD, and KSS, respectively. Temporal association with SARS-CoV-2 was confirmed in 85% of the patients and 38% were admitted to the PICU. The more common clinical manifestations were fever, abdominal pain, rash, and conjunctival injection. Lymphopenia was more common among PICU-admitted patients (87% vs. 51%, p < 0.0001), who also showed a lower platelet count and higher plasmatic levels of inflammatory and cardiac markers. Mitral valve insufficiency, left ventricular wall motion alterations, pericardial effusion, and coronary artery alterations were observed in 30%, 30%, 19.8%, and 18.6% of the patients, respectively. Days to initiation of treatment, rash, lymphopenia, and low platelet count were significant independent contributions to PICU admission. CONCLUSION: Rates of severe outcomes of PIMS-TS in the present study agreed with those observed in high-income countries. Together with other published studies, this work helps clinicians to better understand this novel clinical entity.

Transposición de grandes vasos y aneurisma del septum interventricular. Una asociación poco frecuente / Transposition of great vessels and interventricular septal aneurysm. A rare association

[RESUMEN]: La transposición de grandes vasos es una cardiopatía congénita relativamente frecuente, con baja mortalidad y baja morbilidad si es intervenida quirúrgicamente en el periodo neonatal. Nuestro objetivo es presentar un caso clínico. Se trata de un recién nacido de 7 días de vida que fue derivado del Hospital Oñativia por sospecha de cardiopatía congénita por cianosis persistente. Fue evaluado clínicamente por el Servicio de Cardiología Infantil, se complementó la valoración con un Ecocardiograma transtorácico bidimensional Doppler color. Se realizó el diagnóstico de transposición de grandes vasos con comunicación interventricular muscular grande, aneurisma del septum interventricular y sospecha de anomalía coronaria con trayecto intramural. Fue operado a los 19 días de vida con técnica de switch arterial, cierre de comunicación interventricular, resección del aneurisma del septum y reimplante de las arterias coronarias. Evolucionó exitosamente sin defectos residuales significativos y con ritmo sinusal a su egreso hospitalario.

[ABSTRACT]: Transposition of the great arteries is a relatively frequent congenital heart disease, with low morbidity and mortality if surgery is performed in neonatal period. We aim to describe a case report: A 7 days old newborn was referred from Oñativia Hospital with suspected congenital heart disease due to persistent cyanosis. The child was clinically assessed by the pediatric cardiology department, supporting the evaluation with a transthoracic echocardiogram. A diagnosis of transposition of the great arteries with large ventricular septal defect, interventricular septum aneurysm and probable intramural coronary anomaly was made. An arterial switch procedure was performed at 19 days old, with closure of the ventricular septal defect, resection of the aneurysm of the ventricular septum and coronary arteries reimplantation. The patient evolved favorably, without significant residual defects and with sinus rhythm at the moment of the discharge.

Tetralogía de Fallot y ecocardiografía / Case report: echocardiography in Fallot tetralogy

Tetralogy of Fallot is the most frequent cyanotic congenital heart disease. This is a case report of a pediatric patient who underwent her surgery with the monitorization of tranesopageal echocardiography

La tetralogía de Fallot es la cardiopatía congénita cianosante más frecuente. Se presenta un caso clínico de un paciente pediátrico que se monitorizó con ecocardiografía transesofágica intraoperatoria y se muestran las imágenes y los cambios en el manejo debido a la monitorización ecocardiográfica.