No CrossRef data available.
Article contents
Cardiac effects of COVID-19 infection in children
Published online by Cambridge University Press: 13 September 2024
Abstract
Background:
It is known established that the cardiac effects of COVID-19 infection are associated with poor prognosis and high mortality rates in infected patients. The aim of this study was to evaluate the cardiac effects of COVID-19 infection in paediatric patients and identify the correlations between clinical and laboratory data and the degree of cardiac involvement.
Materials and Methods:
A retrospective data analysis was conducted on 64 paediatric patients at Gazi University Department of Pediatrics who were treated as inpatients with a diagnosis of COVID-19. Patients were classified as “COVID-19-related cardiac involvement cases” if their electrocardiogram and echocardiogram results indicated a pathology and/or if their laboratory data indicated increased cardiac enzymes. All patients were divided into subgroups based on whether they had cardiac involvement and whether they were diagnosed with multisystem inflammatory syndrome in children.
Results:
In comparison to patients who did not have cardiac involvement, those with cardiac involvement had significantly higher levels of hs-Troponin T, Pro-BNP, and D-dimer. Patients with multisystem inflammatory syndrome in children had significantly longer PR intervals than those without multisystem inflammatory syndrome in children (p = 0.0001). Patients with multisystem inflammatory syndrome in children had a significantly higher rate of pathological valve insufficiencies (68.1%) than those without multisystem inflammatory syndrome in children (14.2%) (p = 0.001).
Conclusion:
In our study, the strongest predictive biomarker of cardiac involvement in paediatric patients with COVID-19 infection was determined to be hs-Troponin T. It was observed that pathologic electrocardiogram changes could reflect cardiac involvement in the absence of any other signs. Patients with multisystem inflammatory syndrome in children exhibited significantly greater rates of pathologic echocardiogram findings and myocardial dysfunction than those without multisystem inflammatory syndrome in children. In all patients, pathologic electrocardiogram and echocardiogram findings were found to be strongly associated with the severity of inflammation.
- Type
- Original Article
- Information
- Copyright
- © The Author(s), 2024. Published by Cambridge University Press
References
Magnusson, K, Skyrud, KD, Suren, P, et al. Healthcare use in 700 000 children and adolescents for six months after covid-19: before and after register based cohort study. BMj 2022; 376: e066809.Google Scholar
Guan, WJ, Ni, ZY, Hu, Y, et al. Clinical characteristics of coronavirus Disease 2019 in China. N Engl J Med 2020; 382: 1708–1720.Google Scholar
Saed Aldien, A, Ganesan, GS, Wahbeh, F, et al. Systemic inflammation may induce cardiac injury in COVID-19 patients including children and adolescents without underlying cardiovascular diseases: a systematic review. Cardiovasc Revasc Med 2022; 35: 169–178.Google Scholar
Vasichkina, E, Alekseeva, D, Kudryavtsev, I, et al. COVID-19 heart lesions in children: clinical, diagnostic and immunological changes. Int J Mol Sci 2023; 24: 1147.Google Scholar
Cantarutti, N, Battista, V, Adorisio, R, et al. Cardiac manifestations in children with SARS-COV-2 infection: 1-year pediatric multicenter experience. Children (Basel) 2021; 8: 717.Google Scholar
World Health Organization. Laboratory Testing for Coronavirus Disease 2019 (COVID-19) in Suspected Human Cases: Interim Guidance; 2020. https://apps.who.int/iris/handle/10665/331329
Google Scholar
Corman, VM, Landt, O, Kaiser, M, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Eurosurveillance 2020; 25: 2000045.Google Scholar
Nuccetelli, M, Pieri, M, Gisone, F, Bernardini, S. Combined anti-SARS-coV-2 igA, igG, and igM detection as a better strategy to prevent second infection spreading waves. Immunol Invest 2022; 51: 233–245.Google Scholar
Mitchell, EC, Romano, A, Capone, CA, et al. Multisystem inflammatory syndrome in children: salient echocardiogram findings in the acute phase and longitudinal follow-up. Prog Pediatr Cardiol 2022; 66: 101492.Google Scholar
Azevedo, RB, Botelho, BG, Hollanda, JVG, et al. Covid-19 and the cardiovascular system: a comprehensive review. J Hum Hypertens 2021; 35: 4–11.Google Scholar
Walker, C, Deb, S, Ling, H, Wang, Z. Assessing the elevation of cardiac biomarkers and the severity of COVID-19 infection: a meta-analysis. J Pharm Pharm Sci 2020; 23: 396–405.Google Scholar
Gao, L, Jiang, D, Wen, XS, et al. Prognostic value of NT-proBNP in patients with severe COVID-19. Respir Res 2020; 21: 83.Google Scholar
Ozsurekci, Y, Gürlevik, S, Kesici, S, et al. Multisystem inflammatory syndrome in children during the COVID-19 pandemic in Turkey: first report from the eastern mediterranean. Clin Rheumatol 2021; 40: 3227–3237.Google Scholar
Zhang, W, Zhao, Y, Zhang, F, et al. The use of anti-inflammatory drugs in the treatment of people with severe coronavirus disease 2019 (COVID-19): the perspectives of clinical immunologists from China. Clin Immunol 2020; 214: 108393.Google Scholar
Ponti, G, Maccaferri, M, Ruini, C, Tomasi, A, Ozben, T. Biomarkers associated with COVID-19 disease progression. Crit Rev Clin Lab Sci 2020; 57: 389–399.Google Scholar
Liu, F, Li, L, Xu, M, et al. Prognostic value of interleukin-6, C-reactive protein, and procalcitonin in patients with COVID-19. J Clin Virol 2020; 127: 104370.Google Scholar
Donze, J, Le Gal, G, Fine, M, et al. Prospective validation of the pulmonary embolism severity index. A clinical prognostic model for pulmonary embolism. Thromb Haemost 2008; 100: 943–948.Google Scholar
Lippi, G, Plebani, M. Laboratory abnormalities in patients with COVID-2019 infection. Clin Chem Lab Med 2020; 58: 1131–1134.Google Scholar
Zhamankulov, A, Rozenson, R, Morenko, M, Akhmetova, U, Tyo, A, Poddighe, D. Comparison between SARS-CoV-2 positive and negative pneumonia in children: a retrospective analysis at the beginning of the pandemic. World J Exp Med 2022; 12: 26–35.Google Scholar
Kinikar, AA, Vartak, S, Dawre, R, et al. Clinical profile and outcome of hospitalized confirmed cases of omicron variant of SARS-CoV-2 among children in Pune, India. Cureus 2022; 14: 1.Google Scholar
Abrams, JY, Oster, ME, Godfred-Cato, SE, et al. Factors linked to severe outcomes in multisystem inflammatory syndrome in children (MIS-C) in the USA: a retrospective surveillance study. Lancet Child Adolesc Health 2021; 5: 323–331.Google Scholar
Barman, HA, Atici, A, Alici, G, et al. The effect of the severity COVID-19 infection on electrocardiography. Am J Emerg Med 2021; 46: 317–322.Google Scholar
Reiff, DD, Mannion, ML, Samuy, N, Scalici, P, Cron, RQ. Distinguishing active pediatric COVID-19 pneumonia from MIS-C. Pediatric Rheumatol 2021; 19: 21.Google Scholar
Wang, F, Hou, H, Luo, Y, et al. The laboratory tests and host immunity of COVID-19 patients with different severity of illness. JCI Insight 2020; 5.Google Scholar
Cheung, EW, Zachariah, P, Gorelik, M, et al. Multisystem inflammatory syndrome related to COVID-19 in previously healthy children and adolescents in New York City. JAMA 2020; 324: 294–296.Google Scholar
Çevik, B, Arıcı, Ş., Ergenç, Z, Kepenekli, E, Günal, Ö., Yakut, N. How safe are children with COVID-19 from cardiac risks? Pediatric risk assesment; insights from echocardiography and electrocardiography. Turk J Med Sci 2021; 51: 981–990.Google Scholar
Chao, JY, Derespina, KR, Herold, BC, et al. Clinical characteristics and outcomes of hospitalized and critically ill children and adolescents with coronavirus Disease 2019 at a tertiary care medical center in New York City. J Pediatr 2020; 223: 14–19.e2.Google Scholar
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 2021; 325: 1074–1087.Google Scholar
Consiglio, CR, Cotugno, N, Sardh, F, et al. The immunology of multisystem inflammatory syndrome in children with COVID-19. Cell 2020; 183: 968–970.e7.Google Scholar