New onset severe right ventricular failure associated with COVID-19 in a young infant without previous heart disease

Rodríguez-González, Moisés; Rodríguez-Campoy, Patricia; Sánchez-Códez, María Isabel; Gutiérrez-Rosa, Irene; Castellano-Martínez, Ana; Rodríguez-Benítez, Amado

doi:10.1017/s1047951120001857

Cited by 16 publications

(34 citation statements)

References 8 publications

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“…Cardiovascular involvement in previously healthy children out of PMIS: There is also evidence of cardiac manifestation in previously healthy children out of the setting of PMIS in children. Since the beginning of the pandemic, a few cases have been reported with cardiovascular involvement similar to adults, in the form of myocarditis, pericarditis, heart failure, cardiogenic shock, cardiac arrhythmia, and pulmonary hypertension (PH) (Table 6 )[ 114 - 124 ]. Although infrequent, these cases are usually reported as severe or critically ill patients, pointing out the relevance of the cardiac involvement also in previously healthy children with COVID-19.…”

Section: Resultsmentioning

confidence: 99%

“…Pulmonary hypertension secondary to the primary pulmonary infection or PTE: Right heart failure with increased pulmonary vascular resistance and PH should also be considered as a possible cardiac manifestation in previously healthy children, especially in the context of moderate-severe pneumonia with acute respiratory distress syndrome and hypoxemia[ 132 ]. PH is a well-known complication of pulmonary viral infections leading to adverse outcomes when present, also in the COVID-19 scenario[ 114 , 133 - 136 ]. Interestingly, nonetheless, concomitant pneumonia, PH has not been reported as one of the main characteristic of the disease in children.…”

Section: Resultsmentioning

confidence: 99%

“…Interestingly, nonetheless, concomitant pneumonia, PH has not been reported as one of the main characteristic of the disease in children. Thus, we only found one case of severe PH and right ventricular failure secondary to a severe pulmonary infection in our literature review[ 114 ]. In this case, the increased levels of cardiac troponin and proBNP prompted an echocardiogram realization that diagnosed severe PH.…”

Section: Resultsmentioning

confidence: 99%

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Cardiovascular impact of COVID-19 with a focus on children: A systematic review

Rodríguez-González

Castellano-Martínez

Cascales-Poyatos³

et al. 2020

WJCC

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BACKGROUND Since the beginning of the pandemic, coronavirus disease-2019 (COVID-19) in children has shown milder cases and a better prognosis than adults. Although the respiratory tract is the primary target for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), cardiovascular involvement is emerging as one of the most significant and life-threatening complications of SARS-CoV-2 infection in adults. AIM To summarize the current knowledge about the potential cardiovascular involvement in pediatric COVID-19 in order to give a perspective on how to take care of them during the current pandemic emergency. METHODS Multiple searches in MEDLINE, PubMed were performed using the search terms “COVID-19” or “SARS-CoV-2" were used in combination with “myocardial injury” or "arrhythmia" or “cardiovascular involvement” or "heart disease" or "congenital heart disease" or “pulmonary hypertension” or "long QT" or “cardiomyopathies” or “channelopathies” or "Multisystem inflammatory system" or "PMIS" or “MIS-C” or ”Pediatric multisystem inflammatory syndrome" or "myocarditis" or "thromboembolism to identify articles published in English language from January 1st, 2020 until July 31st, 2020. The websites of World Health Organization, Centers for Disease control and Prevention, and the Johns Hopkins Coronavirus Resource Center were reviewed to provide up to date numbers and infection control recommendations. Reference lists from the articles were reviewed to identify additional pertinent articles. Retrieved manuscripts concerning the subject were reviewed by the authors, and the data were extracted using a standardized collection tool. Data were subsequently analyzed with descriptive statistics. For Pediatric multisystemic inflammatory syndrome temporally associated with COVID-19 (PMIS), multiple meta-analyses were conducted to summarize the pooled mean proportion of different cardiovascular variables in this population in pseudo-cohorts of observed patients. RESULTS A total of 193 articles were included. Most publications used in this review were single case reports, small case series, and observational small-sized studies or literature reviews. The meta-analysis of 16 studies with size > 10 patients and with complete data about cardiovascular involvement in children with PMIS showed that PMIS affects mostly previously healthy school-aged children and adolescents presenting with Kawasaki disease-like features and multiple organ failure with a focus on the heart, accounting for most cases of pediatric COVID-19 mortality. They frequently presented cardiogenic shock (53%), ECG alterations (27%), myocardial dysfunction (52%), and coronary artery dilation (15%). Most cases required PICU admission (75%) and inotropic support (57%), with the rare need for extracorporeal membrane oxygenation (4%). Almost all of these children wholly recovered in a few days, although rare deaths have been reported (2%). Out of PMIS cases we ide...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Cardiovascular impact of COVID-19 with a focus on children: A systematic review

Rodríguez-González

Castellano-Martínez

Cascales-Poyatos³

et al. 2020

WJCC

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“…In this review, further imaging of the abdomen (ultrasound, computed tomography, or magnetic resonance imaging) was performed in 14 of the 39 studies. Only one of those studies had a normal abdominal evaluation [45] . More common findings included ascites ( n = 27 individuals), intestinal/colonic inflammation ( n = 16 individuals), and mesenteric adenopathy ( n = 15 individuals) [ 20 , 26 , 29 , 31 , 32 , 34 , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] ].…”

Section: Discussionmentioning

confidence: 99%

Multisystem inflammatory syndrome in children: A systematic review

et al. 2020

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Background Multisystem inflammatory syndrome in children (MIS-C), also known as pediatric inflammatory multisystem syndrome, is a new dangerous childhood disease that is temporally associated with coronavirus disease 2019 (COVID-19). We aimed to describe the typical presentation and outcomes of children diagnosed with this hyperinflammatory condition. Methods We conducted a systematic review to communicate the clinical signs and symptoms, laboratory findings, imaging results, and outcomes of individuals with MIS-C. We searched four medical databases to encompass studies characterizing MIS-C from January 1st, 2020 to July 25th, 2020. Two independent authors screened articles, extracted data, and assessed risk of bias. This review was registered with PROSPERO CRD42020191515. Findings Our search yielded 39 observational studies ( n = 662 patients). While 71·0% of children ( n = 470) were admitted to the intensive care unit, only 11 deaths (1·7%) were reported. Average length of hospital stay was 7·9 ± 0·6 days. Fever (100%, n = 662), abdominal pain or diarrhea (73·7%, n = 488), and vomiting (68·3%, n = 452) were the most common clinical presentation. Serum inflammatory, coagulative, and cardiac markers were considerably abnormal. Mechanical ventilation and extracorporeal membrane oxygenation were necessary in 22·2% ( n = 147) and 4·4% ( n = 29) of patients, respectively. An abnormal echocardiograph was observed in 314 of 581 individuals (54·0%) with depressed ejection fraction (45·1%, n = 262 of 581) comprising the most common aberrancy. Interpretation Multisystem inflammatory syndrome is a new pediatric disease associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is dangerous and potentially lethal. With prompt recognition and medical attention, most children will survive but the long-term outcomes from this condition are presently unknown. Funding Parker B. Francis and pilot grant from 2R25-HL126140. Funding agencies had no involvement in the study

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“…A systematic search on electronic databases (PubMed, Scopus, medRxiv, and bioRxV) was performed using the terms “children with preexisting PH and SARS-CoV-2”, “PH in children occurring with COVID-19”, “impact of COVID-19 on preexisting PH”, “therapies for PH in COVID-19”, and “PH during COVID-19 pandemic”. There have only been two pre-existing severe PH cases without pulmonary thromboembolism with COVID-19 reported in children: a 16-year-old girl with mitral stenosis and severe PH; and a 6-month-old infant with severe PH and right ventricular (RV) failure [ 4 , 5 ]. One should be cautious when interpreting small case numbers of COVID-19 cases in children with preexisting PH for several reasons.…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and Pulmonary Hypertension in Children: What Do We Know So Far?

Das

2020

Medicina

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The interplay between coronavirus disease 2019 (COVID-19) and pulmonary hypertension (PH) in children is unknown. Adults with PH are at potential risk for severe complications and high mortality due to associated comorbidities. It is difficult to extrapolate the outcomes of COVID-19 in adults to pediatric PH patients. Overall, a small number of COVID-19 cases is reported in patients with preexisting PH. Several factors may be responsible for the low incidence of COVID-19 in children with PH. Pulmonary hypertension is a rare disease, testing is not universal, and patients may have followed more rigorously the Center for Disease Control’s guidelines recommended for personal protection with mask-wearing, social distancing, and hand sanitization through ongoing health education. The small number of COVID-19 cases in patients with preexisting PH does not support that PH is protective for COVID-19. However, medications used to treat PH may have some protection against COVID-19. This review discusses the pathophysiology of PH occurring with COVID-19, differences between children and adults with COVID-19, strategies for management of preexisting PH in children during the ongoing pandemic, and its impact within the field of PH.

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New onset severe right ventricular failure associated with COVID-19 in a young infant without previous heart disease

Cited by 16 publications

References 8 publications

Cardiovascular impact of COVID-19 with a focus on children: A systematic review

Cardiovascular impact of COVID-19 with a focus on children: A systematic review

Multisystem inflammatory syndrome in children: A systematic review

COVID-19 and Pulmonary Hypertension in Children: What Do We Know So Far?

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