RESUMO
This case series examines cardiac MRI findings in four children and adolescents admitted to intensive care in April 2020 for multisystem inflammatory syndrome and Kawasaki disease-like features related to coronavirus disease 2019 (COVID-19). Acute myocarditis occurred less than 1 week after onset of fever and gastrointestinal symptoms. Physical examination showed rash and cheilitis or conjunctivitis. All patients recovered after intravenous immunoglobulin therapy. Severe acute respiratory syndrome coronavirus 2 reverse transcription polymerase chain reaction was negative in nasopharyngeal, stool, and respiratory samples and was positive on serology. Cardiac MRI showed diffuse myocardial edema on T2 short tau inversion-recovery sequences and native T1 mapping, with no evidence of late gadolinium enhancement suggestive of replacement fibrosis or focal necrosis. These findings favor postinfectious myocarditis in children and adolescents with COVID-19.
Assuntos
Infecções por Coronavirus/complicações , Imageamento por Ressonância Magnética/métodos , Pneumonia Viral/complicações , Síndrome de Resposta Inflamatória Sistêmica/diagnóstico por imagem , Síndrome de Resposta Inflamatória Sistêmica/etiologia , Betacoronavirus , COVID-19 , Criança , Feminino , Coração/diagnóstico por imagem , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Masculino , Miocardite/diagnóstico por imagem , Miocardite/etiologia , Miocardite/terapia , Pandemias , SARS-CoV-2 , Síndrome de Resposta Inflamatória Sistêmica/terapia , Resultado do TratamentoRESUMO
Background and Aims: In France, we noted the fifth wave of SARS-CoV2 pandemic, characterized by presence of Omicron variant. This variant is very contagious, but less often aggressive, especially in pediatric population. Methods: We report a case of a 10-year-old girl, previously healthy, not yet vaccinated for SARS-CoV2, presented to our emergency department for left hemiparesis associated with headache and vomiting, without any signs of respiratory tract infection. Results: Cerebral CT and MRI showed an ischemic stroke of right sylvian artery. Magnetic resonance angiography performed upon resurgence of new symptoms was in favor of vasculitis on the right internal carotid and right sylvian artery. PCR SARS-CoV2 was positive for Omicron variant. She fully recovered after few days and was treated with acetylsalicylic acid and intravenous corticosteroids. Conclusion: We report this case to raise awareness on the possible complications related to SARS-CoV2 infection and we highly recommend vaccination in this age group.