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Differences Between Pediatric Acute Myocarditis Related and Unrelated to SARS-CoV-2

Vladislav A Vukomanovic1,2, Stasa Krasic1, Sergej Prijic1,2

  • 1From the Cardiology Department, Mother and Child Health Institute of Serbia, Belgrade, Serbia.

The Pediatric Infectious Disease Journal
|April 13, 2021
PubMed

Insights

Children with acute myocarditis (AM) related to SARS-CoV-2 showed distinct symptoms and faster recovery. AM unrelated to SARS-CoV-2 was associated with more severe outcomes in pediatric patients.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Acute myocarditis (AM) is myocardial inflammation.
  • Distinguishing AM related to SARS-CoV-2 from other causes is crucial for pediatric care.
  • COVID-19 has emerged as a significant factor in pediatric cardiovascular conditions.

Purpose of the Study:

  • To conduct a comparative analysis of acute myocarditis (AM) in children.
  • To identify differences between AM associated with SARS-CoV-2 and AM from other causes.
  • To evaluate clinical presentation, laboratory findings, and outcomes in pediatric AM patients.

Main Methods:

  • Retrospective study of pediatric patients diagnosed with AM between January 2018 and November 2020.
  • Comparison of clinical characteristics, laboratory markers (cTnI, platelets, CRP, BNP), and treatment strategies.
  • Analysis of patient outcomes, including adverse events and recovery of cardiac function.

Main Results:

  • Seven of 24 pediatric patients had AM related to SARS-CoV-2, presenting with abdominal pain, headache, rash, and conjunctivitis.
  • AM unrelated to SARS-CoV-2 was more frequently associated with fulminant myocarditis and adverse outcomes (e.g., death, dilated cardiomyopathy).
  • SARS-CoV-2-related AM showed lower cTnI and platelets, higher CRP, shorter inotropic support duration, and faster left ventricle systolic function recovery.

Conclusions:

  • Pediatric AM related to SARS-CoV-2 exhibits a distinct clinical profile, including a polymorphic presentation and higher CRP levels.
  • Patients with SARS-CoV-2-associated AM experienced shorter inotropic drug requirements and demonstrated prompt recovery of left ventricular systolic function.
  • AM unrelated to SARS-CoV-2 was linked to more frequent severe adverse outcomes in the pediatric population.
Abstract

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