Pediatric endocarditis - a stone left after the pandemic cascade.

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Virology

Background:

• Infective endocarditis (IE) is uncommon in children, typically caused by bacteria.
• Viral IE, including cases linked to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emerged.
• SARS-CoV-2 may induce transient immune deficiency and directly affect cardiac tissue.

Purpose of the Study:

• To review pathophysiological aspects of pediatric cardiac damage from SARS-CoV-2.
• To deepen understanding of systemic damage from viral infections.
• To establish a data foundation for future meta-analyses.

Main Methods:

• Non-systematized literature screening for pediatric endocarditis cases (2020-2023).
• Inclusion of 6 case reports involving 7 pediatric patients (5 children, 2 adolescents).

Main Results:

• SARS-CoV-2 infection may play a role in endocarditis development via direct infection or post-infectious immune response.
• Pre-existing conditions increase the risk of severe, complicated endocarditis.
• Limited data on vaccination status and antibody types (IgM/IgG) pose significant biases.

Conclusions:

• SARS-CoV-2 is a potential contributor to pediatric infective endocarditis.
• Further research is needed to clarify the role of viral infections and vaccination status in pediatric endocarditis.