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Cardiac Sequelae of COVID-19 in Children and Young Adults

Craig P Dobson

    Pediatric Annals
    |May 26, 2021
    PubMed

    Insights

    Coronavirus disease 2019 (COVID-19) can affect the heart during acute infection and as a delayed post-viral inflammatory response. Long-term cardiac consequences remain unknown, necessitating individualized sports clearance protocols.

    Area of Science:

    • Cardiology
    • Infectious Diseases
    • Pediatrics

    Background:

    • Coronavirus disease 2019 (COVID-19) frequently involves cardiac complications.
    • Early cardiac manifestations include pericarditis, myocarditis, and cardiomyopathy.
    • Delayed presentations, such as multisystem inflammatory syndrome and coronary aneurysms, occur post-infection, often testing negative for SARS-CoV-2.

    Purpose of the Study:

    • To review the cardiac manifestations of COVID-19.
    • To discuss current management strategies and the need for long-term outcome data.
    • To highlight the importance of individualized sports clearance for athletes.

    Main Methods:

    • Literature review of COVID-19 cardiac involvement.
    • Analysis of early and delayed cardiac presentations.
    • Evaluation of current sports clearance guidelines for affected athletes.

    Main Results:

    • COVID-19 presents with diverse cardiac issues, both acutely and delayed.
    • Management often adapts guidelines from similar non-COVID conditions (e.g., Kawasaki disease, other myocarditis).
    • Subclinical cardiac involvement is a concern, even in mild cases.

    Conclusions:

    • Individualized assessment is crucial for sports clearance in athletes with a history of COVID-19.
    • Severity of illness, patient age, and sport level must guide return-to-exercise decisions.
    • Further research is needed to understand the long-term cardiac sequelae of COVID-19.

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