Cardiac Involvement in COVID-19 Pediatric Patients During the First Year of Pandemic

Abstract

Background: The coronavirus disease 2019 (COVID-19) is induced by severe acute respiratory syndrome caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The cardiac complications related to COVID-19 include myocardial dysfunction, coronary artery involvement, and arrhythmias. Objectives: This study was designed to evaluate the clinical manifestations, laboratory data, and cardiovascular involvement in hospitalized children with COVID-19. Methods: In this cross-sectional study, all children diagnosed with COVID-19 at Aliasghar Children’s Hospital, Tehran, during the first year of the COVID-19 pandemic (from March 2020 to March 2021) were included. Based on the diagnosis method — polymerase chain reaction (PCR) positive, chest computed tomography (CT) positive, or both — children were divided into three groups: The PCR, CT, and PCR+CT positive. Clinical symptoms and vital signs at admission, hospitalization duration in the ward and intensive care unit (ICU), electrocardiographic (EKG), and echocardiographic results were recorded. Results: Altogether, 47 patients were included, who were positive in COVID-19 PCR in 18, CT in 17, and PCR+CT in 12 patients. The mean hospitalization duration was 9.4 ± 5.43 days. The most common clinical symptoms were constitutional, respiratory, and gastrointestinal complaints. Respiratory rate and temperature decreased significantly at discharge in relation to admission time (P < 0.001). Prolonged QT correction (QTc) was seen in two patients, and one patient had ST elevation. In 5 patients, the left main coronary artery (LMCA) was dilated (Z-score > 2). Various degrees of tricuspid regurgitation in 70.97% and mitral regurgitation in 29.03% of patients were determined, the latter of which was significantly more common among the PCR+CT group (P = 0.03). Conclusions: Although COVID-19 in children may have a less grave presentation than in adults, it could lead to EKG abnormalities, coronary artery dilation, and degrees of tricuspid and mitral valve regurgitation.