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Cardiac injury in children with COVID-19

Published online by Cambridge University Press:  16 May 2023

Joshua M. Herber Open the ORCID record for Joshua M. Herber [Opens in a new window] ,
Samina S. Bhumbra ,
Michael W. Johansen ,
James E. Slaven  and
Ryan M. Serrano
Joshua M. Herber*
Affiliation:
Pediatric Cardiology Department, Riley Hospital for Children, Indianapolis, IN, USA
Samina S. Bhumbra
Affiliation:
Ryan White Center for Pediatric Infectious Diseases and Global Health, Riley Hospital for Children, Indianapolis, IN, USA
Michael W. Johansen
Affiliation:
Pediatric Cardiology Department, Riley Hospital for Children, Indianapolis, IN, USA
James E. Slaven
Affiliation:
Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
Ryan M. Serrano
Affiliation:
Pediatric Cardiology Department, Riley Hospital for Children, Indianapolis, IN, USA
*
Address for correspondence: Dr. J. M. Herber, MD, 705 Riley Hospital Dr. RI 1134, Indianapolis, IN, USA. 46202. 260-415-6869. E-mail: jherber@iu.edu
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Abstract

Background:

There is little known about the spectrum of cardiac injury in acute COVID-19 infection in children.

Methods:

A single-centre, retrospective chart analysis was performed. The protocol was deemed IRB exempt. All patients under the age of 21 years admitted from 20 March, 2020 to 22 June, 2021 for acute symptomatic COVID-19 infection or clinical suspicion of multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 were included. Past medical history, lab findings, echocardiogram and electrocardiogram/telemetry findings, and clinical outcomes were reviewed.

Results:

Sixty-six patients with MIS-C and 178 with acute COVID-19 were reviewed. Patients with MIS-C had more cardiac testing than those with acute COVID-19. Inflammatory markers were more likely elevated, and function was more likely abnormal on echocardiogram in those with MIS-C with testing performed. Among patients with MIS-C, 17% had evidence of coronary dilation versus 0% in the acute COVID-19 group. One (0.6%) patient with acute COVID-19 had clinically significant electrocardiogram or telemetry findings, and this was in the setting of prior arrhythmias and CHD. Four (6%) patients with MIS-C had clinically significant findings on electrocardiogram or telemetry. Among patients with acute COVID-19, extracorporeal membrane oxygenation support was required in 0.6% of patients with acute COVID-19, and there was a 2.8% mortality. There were no deaths in the setting of MIS-C.

Conclusions:

Patients with acute COVID-19 and clinical suspicion of cardiac injury had a lower incidence of abnormal laboratory findings, ventricular dysfunction, or significant arrhythmia than those with MIS-C.

Keywords

COVID-19SARS-CoV-2multisystem inflammatory syndrome in childrenpaediatricscardiologycardiac biomarkers
Type
Original Article
Information
Cardiology in the Young , Volume 34 , Issue 1 , January 2024 , pp. 62 - 66
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Copyright
© The Author(s), 2023. Published by Cambridge University Press

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References

2020 health alert #13: pediatric multi-system inflammatory syndrome potentially associated with COVID-19 (n.d.), https://picsociety.uk/wp-.Google Scholar
Centers for disease control and Prevention. Emergency preparedness and response: HAN00432, 2020. https://emergency.cdc.gov/han/2020/han00432.asp, Accessed December 3, 2020.Google Scholar
Valverde, I, Singh, Y, Sanchez-De-Toledo, J, et al. Acute cardiovascular manifestations in 286 children with multisystem inflammatory syndrome associated with COVID-19 infection in Europe. Circulation 2021; 143: 21–32. DOI 10.1161/CIRCULATIONAHA.120.050065.CrossRefGoogle ScholarPubMed
Rodriguez-Gonzalez, M, Castellano-Martinez, A, Cascales-Poyatos, HM, Perez-Reviriego, AA. Cardiovascular impact of COVID-19 with a focus on children: a systematic review. World J Clin Cases 2020; 8: 5250–5283. DOI 10.12998/wjcc.v8.i21.5250.CrossRefGoogle ScholarPubMed
Feldstein, LR, Tenforde, MW, Friedman, KG, et al. characteristics and outcomes of US children and adolescents with multisystem inflammatory syndrome in children (MIS-c) compared with severe acute COVID-19. JAMA-J Am Med Assoc 2021; 325: 1074–1087. DOI 10.1001/jama.2021.2091.CrossRefGoogle ScholarPubMed
Sperotto, F, Friedman, KG, Son, MBF, VanderPluym, CJ, Newburger, JW, Dionne, A. Cardiac manifestations in SARS-CoV-2-associated multisystem inflammatory syndrome in children: a comprehensive review and proposed clinical approach. Eur J Pediatr 2021; 180: 307–322. DOI 10.1007/s00431-020-03766-6.CrossRefGoogle ScholarPubMed
Metkus, TS, Sokoll, LJ, Barth, AS, et al. Myocardial injury in severe COVID-19 compared with non–COVID-19 acute respiratory distress syndrome. Circulation 2021; 143: 553–565. DOI 10.1161/CIRCULATIONAHA.120.050543.CrossRefGoogle ScholarPubMed
McCrindle, BW, Rowley, AH, Newburger, JW, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a scientific statement for health professionals from the American heart association. Circulation 2017; 135: e927–e999. DOI 10.1161/CIR.0000000000000484.CrossRefGoogle ScholarPubMed
Feldstein, LR, Tenforde, MW, Friedman, KG, et al. Characteristics and outcomes of US children and adolescents with multisystem inflammatory syndrome in children (MIS-C) compared with severe acute COVID-19. JAMA-J Am Med Assoc 2021; 325: 1074–1087. DOI 10.1001/jama.2021.2091.CrossRefGoogle ScholarPubMed
Cantarutti, N, Battista, V, Adorisio, R, et al. Cardiac manifestations in children with sars-cov-2 infection: 1-year pediatric multicenter experience. Children 2021; 8: 717. DOI 10.3390/children8080717.CrossRefGoogle ScholarPubMed