Cardiovascular post-acute sequelae of SARS-CoV-2 in children and adolescents: cohort study using electronic health...

Area of Science:

• Pediatric Cardiology
• Infectious Diseases
• Public Health

Background:

• Cardiovascular risks post-SARS-CoV-2 infection are documented in adults, but data for pediatric populations remain scarce.
• Congenital heart defects (CHDs) may influence cardiovascular outcomes following viral infections in children.

Purpose of the Study:

• To evaluate the risk of diverse cardiovascular outcomes in children and adolescents 28-179 days after SARS-CoV-2 infection.
• To compare these risks between infected and uninfected pediatric cohorts, stratified by the presence of CHDs.

Main Methods:

• Utilized electronic health records (EHR) from 19 US institutions within the RECOVER consortium (March 2020-September 2023).
• Included 297,920 SARS-CoV-2-positive and 915,402 SARS-CoV-2-negative individuals with at least six months of follow-up.
• Assessed outcomes including hypertension, arrhythmias, myocarditis, heart failure, cardiomyopathy, cardiac arrest, thromboembolism, chest pain, and palpitations.

Main Results:

• Children and adolescents with prior SARS-CoV-2 infection demonstrated a statistically significant increased risk of multiple cardiovascular outcomes compared to controls.
• Observed risks included hypertension, ventricular arrhythmias, myocarditis, heart failure, cardiomyopathy, cardiac arrest, and thromboembolism.
• Findings were consistent across pediatric patients with and without pre-existing CHDs.

Conclusions:

• Prior SARS-CoV-2 infection is associated with a heightened risk of significant cardiovascular disorders in children and adolescents.
• This increased risk is evident irrespective of congenital heart defect status.
• Early recognition and management are crucial for mitigating long-term cardiovascular complications in pediatric populations post-SARS-CoV-2 infection.