The Nhlbi Study On Long-term Outcomes After The Multisystem Inflammatory Syndrome In Children (music): Design And Objectives

Dongngan T. Truong, Primary Children's Medical Center
Felicia L. Trachtenberg, HealthCore
Gail D. Pearson, National Heart, Lung, and Blood Institute (NHLBI)
Audrey Dionne, Harvard Medical School
Matthew D. Elias, The Children's Hospital of Philadelphia
Kevin Friedman, Harvard Medical School
Kerri H. Hayes, HealthCore
Lynn Mahony, UT Southwestern Medical School
Brian W. McCrindle, Hospital for Sick Children University of Toronto
Matthew E. Oster, Emory University School of Medicine
Matthew E. Oster, Emory University School of Medicine
Victoria Pemberton, National Heart, Lung, and Blood Institute (NHLBI)
Andrew J. Powell, Harvard Medical School
Mark W. Russell, University of Michigan Medical School
Lara S. Shekerdemian, Baylor College of Medicine
Mary Beth Son, Harvard Medical School
Michael Taylor, Cincinnati Children's Hospital Medical Center
Jane W. Newburger, Harvard Medical School
Therese M. Giglia, Children's Hospital of Philadelphia
Kimberly E. McHugh, Medical University of South Carolina
Andrew M. Atz, Medical University of South Carolina
Scott A. Pletzer, Medical University of South Carolina


Background: The Long-terM OUtcomes after the Multisystem Inflammatory Syndrome In Children (MUSIC) study aims to characterize the frequency and time course of acute and long-term cardiac and non-cardiac sequelae in multisystem inflammatory syndrome in children associated with COVID-19 (MIS-C), which are currently poorly understood. Methods: This multicenter observational cohort study will enroll at least 600 patients <21 years old who meet the Centers for Disease Control and Prevention case definition of MIS-C across multiple North American centers over 2 years. The study will collect detailed hospital and follow-up data for up to 5>years, and optional genetic testing. Cardiac imaging at specific time points includes standardized echocardiographic assessment (all participants) and cardiac magnetic resonance imaging (CMR) in those with left ventricular ejection fraction (LVEF) <45% during the acute illness. The primary outcomes are the worst LVEF and the highest coronary artery z-score of the left anterior descending or right coronary artery. Other outcomes include occurrence and course of non-cardiac organ dysfunction, inflammation, and major medical events. Independent adjudication of cases will classify participants as definite, possible, or not MIS-C. Analysis of the outcomes will include descriptive statistics and regression analysis with stratification by definite or possible MIS-C. The MUSIC study will provide phenotypic data to support basic and translational research studies. Conclusion: The MUSIC study, with the largest cohort of MIS-C patients and the longest follow-up period to date, will make an important contribution to our understanding of the acute cardiac and non-cardiac manifestations of MIS-C and the long-term effects of this public health emergency.