Long-term Cardiovascular and Psychologic Outcomes of Multisystem Inflammatory Syndrome in Children: A Prospective Observational Study (COPE MIS-C study)

Background: Multisystem inflammatory syndrome in children (MIS-C) is associated with favorable short-term outcomes. However, long-term follow-up data are limited, particularly from low- and middle-income countries. Methodology: This prospective follow-up study was conducted at a tertiary care hospital in North India between November 2024 and September 2025, involving children (n = 51) admitted with MIS-C and discharged between September 2020 and August 2022. The data collected included the clinical profile, echocardiography (left ventricular ejection fraction and coronary artery diameters), Screen for Child Anxiety–Related Disorders scale, UCLA Post-traumatic Stress Disorder Reaction Index and Vineland Social Maturity Scale. Results: During the acute phase, common manifestations included fever, gastrointestinal and mucocutaneous involvement, shock, elevated inflammatory markers, myocardial dysfunction (47%) and coronary abnormalities (22%). At follow-up 44 (43–46) months after discharge, none had major clinical symptoms; all had normalized left ventricular ejection fraction, normal school performance and peer relationships; and only 12% had mild coronary artery abnormalities. There were no anxiety or post-traumatic stress disorder–related symptoms, and all had age-appropriate social maturity. Conclusions: Long-term outcomes of MIS-C are favorable, with complete recovery of myocardial function, persistent mild coronary abnormalities in a small proportion, no anxiety or post-traumatic stress disorder, and normal social maturation.