Cardiac Abnormalities seen in pediatric patients during the SARS-CoV2 pandemic: An international experience

Authors

Bradley C. Clark, Albert Einstein College of Medicine Bronx NY.
Joan Sanchez-de-Toledo, Hospital Sant Joan de Deu Barcelona Spain
Carles Bautista-Rodriguez, National Heart and Lung Institute Imperial College London UK.
Nadine Choueiter, Albert Einstein College of Medicine Bronx NY.
Diego Lara, Ochsner Health New Orleans LA.
Hechaan Kang, National Heart and Lung Institute Imperial College London UK.
Shazia Mohsin, Aga Khan UniversityFollow
Alain Fraisse, National Heart and Lung Institute Imperial College London UK.
Sergi Cesar, Hospital Sant Joan de Deu Barcelona Spain
Nadeem Aslam, Aga Khan UniversityFollow

Document Type

Article

Department

Paediatrics and Child Health

Abstract

Background: During the SARS‐CoV2 pandemic, there has been increase in hyperinflammatory presentation in previously healthy children with a variety of cardiac manifestations. Our objective is to describe the cardiac manifestations found in an international cohort of 55 pediatric cases with multi‐system inflammatory syndrome (MIS‐C) during the SARS‐CoV2 pandemic.
Methods and Results: We reviewed data on previously healthy pediatric patients (≤18 years) with structurally normal hearts who presented at hospitals in the United States, United Kingdom, Spain and Pakistan with MIS‐C and had consultation with a pediatric cardiologist. Data collected included demographics, clinical presentation, laboratory values, electrocardiographic abnormalities, echocardiographic findings and initial therapies. A total of 55 patients presented with MIS‐C. Thirty‐five patients (64%) had evidence of decreased left ventricular function, 17 (31%) had valvulitis, 12 (22%) with pericardial effusion and 11 (20%) with coronary abnormalities. Twenty‐seven (49%) required ICU admission and 24 (44%) had evidence of shock. Eleven patients (20%) fulfilled complete Kawasaki disease criteria and had lower NT pro‐BNP, D‐dimer and ferritin levels compared with those who did not fulfill criteria. Electrophysiologic abnormalities occurred in 6 patients and included complete atrioventricular (AV) block, transient AV block and ventricular tachycardia.
Conclusions: We describe the first international cohort of pediatric patients with MIS‐C during the SARS‐CoV2 pandemic with a range of cardiac manifestations. This paper brings awareness and alertness to the global medical community to recognize these children during the pandemic and understand the need for early cardiology evaluation and follow‐up.

Comments

Volume, issue, and pagination are not provided by the author/publisher

Publication (Name of Journal)

Journal of the American Heart Association

Recommended Citation

Clark, B. C., Sanchez-de-Toledo, J., Bautista-Rodriguez, C., Choueiter, N., Lara, D., Kang, H., Mohsin, S., Fraisse, A., Cesar, S., Aslam, N. (2020). Cardiac Abnormalities seen in pediatric patients during the SARS-CoV2 pandemic: An international experience. Journal of the American Heart Association, e018007.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_paediatr/928