COVID-19: The disease, the vaccine and the heart

Coronavirus SARS-CoV-2 has fundamentally affected the health, healthcare delivery and daily life in all populations and age groups in Australia. The aim of this report is to summarise how it has affected the paediatric population with an emphasis on, but not limited to, the cardiac manifestations. A literature review and appraisal of data relating to SARS-CoV-2 cardiac manifestations and vaccination in the paediatric population was undertaken.The majority of children with SARS-CoV-2 infection recover well. However, a very small proportion may develop severe acute disease. In the sub-acute phase, children may also develop a Kawasaki like illness, Paediatric Inflammatory Multisystem Syndrome temporally associated with SARS-CoV-2. Whilst not directly cardiac in nature, SARS-CoV-2 also affected children in other profound ways. Public health measures with widespread lockdowns appeared to disproportionately affect the paediatric population causing physical deconditioning and psychological harm. Vaccination against SARS-CoV-2 has proven to be safe and effective, but the small rate of complications did disproportionately affect teenage children with risks of myocarditis and pericarditis. The long term outcomes following myocarditis related to SARS-Cov-2 vaccination are yet to be clarified. When treating children in the era of SARS-CoV-2, Paediatricians need to be well aware of the risks of infection in the acute and sub-acute phases, have a good understanding of the well-established recommendations for vaccination, and also be cognisant of psychological impacts.