Cardiogenic Shock Associated with PIMS-TS- De Novo Myocardial Involvement or Subacute COVID-19- Myocarditis? Discussions Around a Case Report and Literature Review

Marcela Daniela Ionescu, Cristina Filip, Lavinia Isabella Marin, Liana Catalina Gavriliu, Maria Cristina Stefan and Mihaela Balgradean

Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, Romania
"Marie S. Curie" Emergency Children's Clinical Hospital, Romania
Department of Infectious Disease, Carol Davila University of Medicine and Pharmacy, Romania

^*Correspondance to: Cristina Filip 

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Abstract:

We describe a case of Pediatric Inflammatory Multisystem Syndrome Temporally associated with SARS-CoV-2 (PIMS-TS) in a 6-year-old boy, who developed signs and symptoms of cardiogenic shock in an early stage. The echocardiography revealed severe systolic dysfunction, mild pleural and pericardial effusion, and coronary artery dilation. The patient developed multiorgan dysfunction and received treatment with intravenous immunoglobulin, Interleukin-1 receptor antagonist, and high doses of corticosteroids, vasoactive and inotropic support, anticoagulant therapy, and diuretics with complete resolution of clinical heart failure and normalized Left Ventricle (LV) ejection fraction within 10 days. Further studies are necessary to know if a better prognosis in PIMS-TS related severe myocarditis is expected in patients with previously normal myocardium compared with patients with myocardial damage in acute phase of SARS-CoV-2 infection through direct injury of the virus (non-immune mechanism).

Keywords:

COVID-19; Infection; Children; PIMS-TS; Cardiogenic shock; Treatment; Kawasaki Disease Shock Syndrome

Cite the Article:

Ionescu MD, Filip C, Marin LI, Gavriliu LC, Stefan MC, Balgradean M. Cardiogenic Shock Associated with PIMS-TS- De Novo Myocardial Involvement or Subacute COVID-19- Myocarditis? Discussions Around a Case Report and Literature Review. Clin Case Rep Int. 2021; 5: 1253.