Cardiac manifestations in pediatric COVID-19

Capucho, Ana Carolina Marques do Vale; Resende, Paola Laureza Silva; Mascarenhas, Daniel Alves; Silva, Camila Lino Martins Rodrigues da; Sawamura, Karen Saori Shiraishi; Menezes, Carolina da Rocha Brito; Diniz, Maria de Fátima Rodrigues; Lianza, Alessandro Cavalcanti; Carvalho, Werther Brunow de; Silva, Clóvis A.; Leal, Gabriela Nunes

doi:10.6061/clinics/2021/e3001

Cited by 3 publications

(1 citation statement)

References 31 publications

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“…Only one patient with reduced LV EF is described as having left ventricle thrombosis, while three patients with COVID-19 had normal LV EF, but all patients had central venous catheters. [21][22][23]. Our patient with LV thrombosis had normal LV EF without contributing risk factors.…”

Section: Discussionmentioning

confidence: 57%

Analysis of cardiac manifestation and treatment of multisystem inflammatory syndrome in children related to SARS-CoV-2

Krasić

Ninić

Prijić

et al. 2022

Bosn J of Basic Med Sci

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Cardiovascular manifestations are common (35-100%) in the multisystem inflammatory syndrome in children. Our study aimed to analyze treatment impact and cardiovascular involvement in patients with multisystem inflammatory syndrome in children. The retrospective cohort included 81 patients treated between April 2020 and December 2021 (9.3±4.6 years).Elevated cardiac troponin I and pro-B-type natriuretic peptide were observed in 34.2% and 88.5% of patients, respectively. Myocardial dysfunction was observed in 50.6%. Children older than 10 years had a 4-fold increased risk of myocardial dysfunction (odds ratio [OR] 3.6, 95% confidence interval [CI] 1.4-8.9; p=0.006). A moderate negative correlation was proved between left ventricular ejection fraction and C-reactive protein (rr = -0.48; p < 0.001). More than one-fifth of the patients presented with shock. Coronary artery dilatation was observed in 6.2% of patients.Mild pericardial effusion was detected in 27.1% of children. On standard electrocardiogram, 52.6% of children had negative T waves in the inferior and/or precordial leads; transient QTc prolongation was registered in 43% of patients. Treatment failure was observed in 19 patients.Patients initially treated with intravenous immunoglobulins had 10-fold higher chances for treatment failure than patients treated with corticosteroids (OR 10.6, 95% CI 3,; p < 0.001). Cardiovascular manifestations were observed in more than half of the patients, with acute myocardial dysfunction being the most common, especially in children older than 10 years. We established a negative association between the degree of elevation of inflammatory markers and left ventricular ejection fraction. Patients treated with intravenous immunoglobulins who had cardiovascular manifestations had treatment failures more frequently than patients treated with corticosteroids.

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Section: Discussionmentioning

confidence: 57%

Analysis of cardiac manifestation and treatment of multisystem inflammatory syndrome in children related to SARS-CoV-2

Krasić

Ninić

Prijić

et al. 2022

Bosn J of Basic Med Sci

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A Lung Ultrasound-Based Comparison of Postoperative Respiratory Outcome after Pediatric Congenital Heart Surgery in COVID-19 Recovered and COVID-19 Unaffected Children-A Pilot Study

Munaf,

Palamattam,

Menon

et al. 2023

Annals of Cardiac Anaesthesia

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Background: COVID-19 is known to affect the alveolar-capillary membrane and interstitial tissue. Cardiopulmonary bypass (CPB) is proven to cause “pump-lung” syndrome. Little is known about the subgroup of COVID-19-recovered children undergoing cardiac surgeries under CPB. Aim: To compare the lung ultrasound score (LUSS) and morbidity of COVID-19-recovered children to those without COVID-19 after congenital cardiac surgery. Setting and Design: Prospective observational pilot study at a tertiary care institution. Materials and Methods: The study was carried out on 15 COVID-recovered children and 15 matched controls (Group B) posted for congenital cardiac surgery. COVID-recovered children were further divided into those who received in-hospital care for COVID (Group C) and those who did not (Group A). LUSS measured immediately after cardiac surgery was compared between the groups. PaO₂/FiO₂ ratio, incidence of pulmonary infection, re-intubation rate, duration of ventilation, in-hospital mortality, and 30-day mortality were also compared between the groups. Results: LUSS was comparable between Groups A and B (mean difference = 1.467, P = 0.721). Compared to the control group, Group C showed higher LUSS (mean difference = 11.67, P < 0.001), lower PaO2/FiO2 ratio (207.8 ± 95.49 Vs 357.6 ± 63.82, P = 0.003), and one in-hospital mortality. A significant negative correlation was seen between LUSS and PaO2/FiO2 ratio (rs = - 0.75, P < 0.001). Conclusion: LUSS was not higher in COVID-recovered children. Children with a history of severe COVID-19 recorded higher LUSS, in-hospital mortality, duration of ICU stay, and duration of ventilation.

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Functional state of the cardiovascular system in children after COVID-19

Isaeva,

Zaytseva,

Lokshina

et al. 2023

RPJ

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Introduction. The new coronavirus infection (COVID-19) in children often occurs in a mild, moderate, or asymptomatic. After experiencing COVID-19, some children, as well as adults, had persistent symptoms over more than 12 weeks and could not be explained by alternative diagnoses. These changes are called Post-acute COVID-19 Syndrome (PACS, post-COVID-19 syndrome or post-covid syndrome). Clinical manifestations of post-covid syndrome in children are very diverse, there are combinations of autonomic, psycho-emotional, cognitive and somatic disorders, including disorders of the cardiovascular system. Aim: analysis of changes in the functional state of the cardiovascular system in children in the post-covid period. Materials and methods. The study included one hundred thirty one child aged of 5 to 17 years 11 months 29 days (mean age 12 years [9.5; 15]). The observed children were divided into 2 groups: group 1 (main) — children who had a mild new coronavirus infection (n = 76). The comparison group consisted of children who did not have COVID-19, suffered from acute respiratory viral infections of unspecified etiology of a mild course (n = 55). All children were analyzed for medical history, underwent clinical examination, electrocardiographic examination (ECG), echocardiographic examination (ECHO-KG), 24-hour Holter ECG monitoring and 24-hour blood pressure (BP) monitoring. Results. Children who have had COVID-19 are significantly more often showed sinus tachycardia (p = 0.025), extrasystole (supraventricular, ventricular) (p = 0.046), atrioventricular blockade of the 2nd degree (p = 0.027) compared with children with ARVI. After undergoing COVID-19, in 19.7% of children an increase in blood pressure was detected, in 15.8% of children there was a significant decrease in blood pressure at night (p = 0.008). In 38.2% of children after COVID-19, there was a decrease in the activity of the parasympathetic division of the nervous system. Conclusion. Children who have had a new mild coronavirus infection were shown to undergo a clinical examination with a mandatory assessment of blood pressure, heart rate and an ECG 3 and 6 months after the illness.

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Cardiac manifestations in pediatric COVID-19

Cited by 3 publications

References 31 publications

Analysis of cardiac manifestation and treatment of multisystem inflammatory syndrome in children related to SARS-CoV-2

Analysis of cardiac manifestation and treatment of multisystem inflammatory syndrome in children related to SARS-CoV-2

A Lung Ultrasound-Based Comparison of Postoperative Respiratory Outcome after Pediatric Congenital Heart Surgery in COVID-19 Recovered and COVID-19 Unaffected Children-A Pilot Study

Functional state of the cardiovascular system in children after COVID-19

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