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Long-term Effects of SARS-CoV-2 Infection on Children's Vasculature
Dareilena Karaviti1, Marietta Charakida1, Dimitra Dimopoulou1
1From the Second Department of Pediatrics.
Insights
Long COVID in children shows endothelial activation but no lasting arterial changes. About a quarter of infected children experienced long COVID symptoms, suggesting unique childhood post-COVID conditions.
Area of Science:
- Pediatric vascular health
- Infectious disease epidemiology
- Long-term health outcomes
Background:
- Long COVID in adults is associated with persistent vascular dysfunction.
- Limited research exists on the long-term vascular effects of COVID-19 in children.
- Understanding pediatric post-COVID vascular health is crucial for long-term management.
Purpose of the Study:
- To assess vascular health in children approximately 6.8 months after COVID-19 infection.
- To compare vascular parameters between children with and without a history of COVID-19.
- To investigate potential long-term vascular sequelae in pediatric COVID-19 survivors.
Main Methods:
- A cohort of 223 children was divided into COVID-19 survivors (group 1) and healthy controls (group 2).
- Vascular health was evaluated using pulse wave velocity (PWV) and carotid intima-media thickness (cIMT).
- Biomarkers, lipid profiles, and long COVID symptoms were assessed.
Main Results:
- Elevated soluble intercellular adhesion molecule-1 levels were observed in COVID-19 survivors.
- Pulse wave velocity was initially higher in survivors but normalized after adjusting for BMI and blood pressure.
- No significant differences in carotid intima-media thickness or inflammatory markers were found between groups.
- Long COVID symptoms were reported by 23.6% of COVID-19 survivors compared to 3.8% of controls.
Conclusions:
- COVID-19 infection in children may lead to endothelial activation without significant structural arterial changes.
- Persistent inflammation was not evident post-infection, but long COVID symptoms were common.
- The pathophysiology of post-acute COVID-19 infection in children may differ from adults.
Background:
While long coronavirus disease 2019 (COVID-19) is linked to prolonged vascular dysfunction in adults, research in children remains poor. In this study, we assessed vascular health in children infected with severe acute respiratory syndrome coronavirus 2 about 6.8 months postinfection, comparing them with healthy controls.
Methods:
Two hundred twenty-three children were assessed and divided into group 1, which included children with a positive disease history and group 2, which consisted of healthy controls. Anthropometric measurements, lipid profile, biomarkers (interleukin-6, C-reactive protein, tumor necrosis factor-alpha and soluble intracellular adhesion molecule) and long COVID symptoms were assessed, along with pulse wave velocity (PWV) measurements and carotid intima-media thickness (cIMT) to evaluate aortic stiffness.
Results:
Children in group 1 were older (mean age: 10.8 ± 3.2 years vs. 8.5 ± 2.8 years, P < 0.001) and had higher body mass index (20.3 ± 5.6 kg/m 2 vs. 18.4 ± 3.5 kg/m 2 , P < 0.001). PWV was increased in group 1 (5.02 ± 0.7 m/s vs. 4.7 ± 0.6, P < 0.001). However, vascular differences between the groups disappeared after adjusting for age, body mass index, and blood pressure. Soluble intracellular adhesion molecule-1 levels were elevated in children with a history of moderate/severe COVID-19 infection compared with controls (555.8 ± 113.2 ng/mL vs. 428 ± 42.6 ng/mL, P < 0.001). Cholesterol levels, inflammatory markers and cIMT were comparable between groups. Long COVID symptoms were reported mainly by participants of group 1 [34 (23.6%) vs. 3 (3.8%), P < 0.001].
Conclusions:
This study demonstrates insights into the long-term effects of COVID-19 infection in children. Evidence of endothelial activation without structural arterial changes was found. Persistent inflammation postinfection was absent, yet approximately one-quarter of the participants experienced long COVID symptoms, indicating potential differences in the pathophysiology of postacute COVID-19 infection in childhood.
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