Cardiac involvement in a child post COVID-19: a case from Le
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COVID-19 is uncommon in children, however, early diagnosis of MIS?C is essential for the management and the prevention of a severe inflammatory state. Following SARS-CoV-2 infection, the worldwide burden of the novel syndrome, MIS-C continues to escalate in the paediatric age group. Taking into consideration the fact that MIS-C can mimic other diseases including but not limited to KD, this can make the diagnosis easily overlooked. The aim of this report is to describe one of the earliest cases of MIS-C in Lebanon, shedding light on the presentation and management with focus on cardiac involvement.

An 8-year-old boy presented to the emergency department with fever, generalised oedema and hypotension. Investigations revealed anaemia, thrombocytopenia in addition to elevated serum inflammatory markers, a negative COVID-19 PCR test and a positive COVID-19 IgG.

His echocardiography was consistent with carditis in otherwise morphologically normal heart with depressed cardiac function, moderate-to-severe mitral valve regurgitation, moderate tricuspid regurgitation with an estimated right ventricular systolic pressure half systemic, trace aortic regurgitation, bilateral small pleural effusions, distended inferior vena cava and normal coronaries.

He was started on inotropic support, intravenous immunoglobulin and methylprednisolone, and was transferred to the paediatric intensive care unit. To the best of knowledge, this was the first case of multisystem inflammatory syndrome in children encountered in Lebanon.