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Case report: VA-ECMO for fulminant myocarditis in an infant with acute COVID-19

Hao-Ting Hsu1, Ni-Chun Kuo1, Po-Yen Chen1

  • 1Department of Pediatrics, Children's Medical Center, Taichung Veterans General Hospital, Taichung, Taiwan.

Frontiers in Pediatrics
|July 13, 2023
PubMed

Insights

Coronavirus disease 2019 (COVID-19) rarely caused severe myocarditis in children. This case highlights a 9-month-old infant’s successful recovery from COVID-19-related fulminant myocarditis and cardiogenic shock.

Area of Science:

  • Pediatric Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Fulminant myocarditis is a rare but serious condition in children, potentially leading to high morbidity and mortality.
  • The coronavirus disease 2019 (COVID-19) pandemic presented unique challenges in pediatric critical care.
  • Understanding the impact of COVID-19 on pediatric cardiovascular health is crucial.

Observation:

  • A previously healthy 9-month-old infant presented with rapid deterioration.
  • The infant developed cardiogenic shock secondary to COVID-19-related fulminant myocarditis.
  • Severe heart failure and multiple organ dysfunction syndrome were observed.

Findings:

  • Prompt treatment with central venoarterial extracorporeal membrane oxygenation (ECMO) and continuous venovenous hemofiltration (CVVH) was initiated.
  • The infant demonstrated a positive clinical response to intensive interventions.
  • Successful management led to a good recovery without significant long-term morbidity.

Implications:

  • This case underscores the potential severity of COVID-19 in infants, even with rare complications like fulminant myocarditis.
  • Advanced life support technologies like ECMO and CVVH are vital for managing pediatric critical illness.
  • Early recognition and aggressive treatment can lead to favorable outcomes in severe pediatric cardiovascular emergencies.

Keywords:
COVID-19VA-ECMOcoronavirus disease 2019fulminant myocarditismyocarditispediatric

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