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Cardiac injury in children with COVID-19

Published online by Cambridge University Press:  16 May 2023

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

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.

Type
Original Article
Copyright
© The Author(s), 2023. Published by Cambridge University Press

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