Cardiac Manifestations in COVID-19 Patients: A Focus on the Pediatric Population

Abstract

Background. SARS-CoV-2 is a new strain of the coronavirus family that emerged by the end of 2019 and led to the unpreceded COVID-19 pandemic. The virus affects multiple organs simultaneously and leads to a high rate of morbidity and mortality in all age groups. The cardiovascular system is one of the major affected organ systems. Various mechanisms including direct myocardial injury contribute to the cardiac manifestations of COVID-19 patients. Methods. We performed a comprehensive and updated search on the cardiac manifestations of COVID-19. Our search included laboratory and imaging evaluations. In addition, we added a unique section on the effect of SARS-CoV-2 on the cardiovascular system in the pediatric population. Results. COVID-19 might have an effect on the cardiovascular system at various levels leading to myocardial ischemia, arrhythmia, heart failure, myocarditis, and multisystem inflammatory syndrome in children. The incidence of cardiovascular complications varies among patients. This paper also provides a comprehensive summary of all the reported pediatric cases with cardiac manifestations. Conclusion. Multidisciplinary teams are crucial for adequate management of patients with COVID-19 regardless of age. Timely diagnosis is critical in reducing mortality.

Aspirin in COVID-19: Pros and Cons

“…Aspirin was also proved to be beneficial in preventing preeclampsia, and more ongoing trials are exploring the role of aspirin in reducing the risk of colorectal cancer ( Roberge et al, 2018 ) ( Dubé et al, 2007 ). In pediatrics, aspirin is used in patients with congenital heart disease and recently in treating multisystem inflammatory syndrome in children ( Abani et al, 2021 ; Abi Nassif et al, 2021 ).…”

„Coronavirus disease 2019 (COVID‑19)“ im Kindes- und Jugendalter

“…„Peri- oder Myokarditis nach COVID‑19-Impfung“) ist von besonderem Interesse, in welchem Umfang SARS-CoV‑2-Infektionen mit einer kardialen Manifestation einhergehen. Ein im Juli 2021 veröffentlichter Review [ 11 ] fasst 14 Publikationen, die kardiale Ereignisse bei 515 jugendlichen COVID‑19 Patienten dokumentieren, zusammen. Die Inzidenz kardiovaskulärer Komplikationen bei COVID‑19 variiert zwischen Patientenkollektiven und kann mit Myokardischämie, Arrhythmie, Herzinsuffizienz, Myokarditis meist im Rahmen eines Multisystementzündungssyndroms bei Kindern einhergehen.…”

Case report: Increased troponin level in 125 children during COVID-19

“…SARS-CoV-2 mainly affects the upper respiratory tract. Nevertheless, the virus can damage other tissue than lung through a direct injury or an indirect one caused by the release of proinflammatory cytokines (4). An exaggerated inflammatory response triggered by the cytokine storm could cause a multiorgan involvement (5).…”

“…Macrophages and T-cell lymphocytes accumulate in the damaged vessel wall, initiating a chronic form of vasculitis, with proliferation of myofibroblasts and risk for coronary artery stenosis. In the early acute phase, myocardial edema characterizes myocarditis before evidence of an aneurysm, with possibly transient left ventricular dysfunction that can lead to cardiovascular shock (4).…”