Using Cpet To Evaluate Possible Long-term-effects Of Multisystem Inflammatory Syndrome (mis-c) In Pediatric Populations

Multisystem inflammatory syndrome (MIS-C) is a life-threatening condition that has been primarily associated with SARS-CoV-2 infection in children and adolescents. The long-term sequela of MIS-C is largely unknown. Returning to physical activity and exercise after experiencing MIS-C requires a cautious and gradual approach. PURPOSE: to evaluate possible cardiopulmonary limitations in children and adolescents previously hospitalized for MIS-C. METHODS: Six MIS-C patients with a history of hospitalization (age 9-14y/o), 11 SARS-CoV-2 infection symptomatic patients (8-18y/o), and 8 self-reported no history of SARS-CoV-2 infection control group (8-18y/o) completed Cardiopulmonary Exercise Testing (CPET). Both groups of patients were in the 9-12-month range post their illness. Anthropometric, demographic, and physical activity data was collected. Peak V̇O2, ΔV̇O2 /ΔWR, ΔV̇O2 /ΔHR, ΔV̇E/ΔV̇CO2 were calculated and compared to predicted values for sex and age groups (Cooper et al., 2014). Mean contrasts were performed for each subgroup pairing, with t-tests and effect sizes evaluated for each primary outcome. RESULTS: MIS-C group had significantly higher BMI %ile (83.3% compared to 45.8% and 44.75%; p = .023, cohen’s d = 1.34) and decreased physical activity levels (5.2 hr. per week, compared to 9.1 and 17.5 hr. in the SARS-CoV-2 and control groups F = 6.68, p = .005). MIS-C peak V̇O2 values were 83 ± 19% predicted, ΔV̇E/ΔV̇CO2 was 79.8 ± 12.4%, predicted and ΔV̇O2 /ΔHR tended to be lower than the comparison group. CONCLUSION. Overall, our data suggest a difference in CPET in the MISC group compared to our controls and standardized normal values. It remains uncertain whether the increased BMI%ile and decreased levels of physical activity levels observed in the MIS-C group (and the associated results of CPET) stem from a cause or effect relationship. The initial findings from this project serve as first stride in understanding the long-term consequences of MIS-C and will support shaping the guidelines for returning to physical activity and exercise after recovering from the illness. Yes