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Cardiac Dysfunction and Shock in Pediatric Patients With COVID-19

Krittika Joshi1, Daniel Kaplan2, Adnan Bakar2

  • 1Department of Pediatric Cardiology, Cohen Children's Medical Center, Zucker School of Medicine, Hofstra University, New Hyde Park, New York.

JACC. Case Reports
|August 25, 2020
PubMed

Insights

Coronavirus disease-2019 (COVID-19) can cause cardiac inflammation and shock in previously healthy children, a condition previously only seen in adults. This study highlights the potential for severe cardiac complications in pediatric COVID-19 cases.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coronavirus disease-2019 (COVID-19) primarily affects adults, with children generally experiencing milder symptoms.
  • Cardiac dysfunction has been documented in adult COVID-19 patients.
  • Limited data exists on severe cardiac manifestations in pediatric COVID-19 cases.

Observation:

  • Three previously healthy children presented with symptoms of shock.
  • All three children had confirmed COVID-19 infections.
  • Clinical presentation suggested significant cardiac inflammation.

Findings:

  • The pediatric cases exhibited shock and myocardial inflammation, mirroring severe adult COVID-19 cardiac complications.
  • These findings indicate that children can experience severe cardiac dysfunction due to COVID-19.
  • This challenges the notion of uniformly milder disease in pediatric populations.

Implications:

  • Pediatricians and critical care providers should consider COVID-19-related cardiac inflammation in children presenting with shock.
  • Early recognition and management of cardiac dysfunction are crucial in pediatric COVID-19.
  • Further research is needed to understand the long-term cardiac sequelae in children post-COVID-19.

Keywords:
AKI, acute kidney injuryCOVID-19COVID-19, coronavirus disease-2019ED, emergency departmentFS, fractional shorteningIVIG, intravenous immunoglobulinLVEF, left ventricular ejection fractionPCR, polymerase chain reactionPICU, pediatric intensive care unitTTE, transthoracic echocardiogramVIS, vasoactive ionotropic scorecardiac injuryhsTnT, high-sensitivity troponin Tmyocarditispediatricshock

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