COVID-19 can cause heart injuries in children, warn cardiologists

Cases of COVID-19 can cause heart injuries in young children, according to to a case report and warning from the American College of Cardiology.

Myocardial injuries have been reported in a number of adult patients since the earliest days of the coronavirus pandemic, but there have been assumptions that most children will be asymptomatic of infection.

Studies have found that up to 28% of adult patients hospitalised with COVID-19 have also developed myocardial injuries, although most of these adults had pre-existing cardiovascular disease.

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Similar injuries could be occurring in children with the disease, according to a new warning, based on the case report of a two-month old infant who experienced reversible myocardial injury and heart failure after being diagnosed with COVID-19.

According to the peer-reviewed Journal of the American College of Cardiology, the baby – whose first test for the virus came back negative – presented with choking and bluish discolouration of their skin after feeding.

A subsequent test for the virus returned a positive result.

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The child had been born pre-term at 33 weeks and spent the first three weeks of their life in a natal intensive care unit, receiving a week of continuous positive airway pressure nasally.

They did not have a history of “fever, cough, upper respiratory tract infection symptoms, diarrhoea, vomiting or decreased feeding prior to the first presentation” the ACC said.

When the clinicians performed an electrocardiogram they found the coronavirus infection had caused the injuries to the child’s heart muscles, and exacerbated their heart failure symptoms too.

Additional tests ruled out all other possible viral causes for the heart injury.

The baby received fluid resuscitation and mechanical ventilation for respiratory failure – as well as the experimental drug remdesivir under a compassionate use order.

Following the treatment, the child recovered with normal heart function and was discharged without being issued any medications for heart failure.

“The presentation and clinical course of this patient mirrors four case reports of acute myocardial injury reported in adult patients with COVID-19,” said Dr Madhu Sharma, lead author of the case report and a paediatric cardiologist at The Children’s Hospital at Montefiore.

“Most children with COVID-19 are either asymptomatic or have mild symptoms, but our case shows the potential for reversible myocardial injury in infants with COVID-19.

“Testing for COVID-19 in children presenting with signs and symptoms of heart failure is very important as we learn more about the impact of this virus,” Dr Sharma added.

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