Elevated cardiac biomarkers and outcomes in children and adolescents with acute COVID-19

• Published in: Cardiology in the Young Vol. 33; no. 2; pp. 183 - 189
• Main Authors: Fremed, Michael A., Healy, Emma W., Choi, Nak Hyun, Cheung, Eva W., Choudhury, Tarif A., Jiang, Pengfei, Liberman, Leonardo, Zucker, Jason, Lytrivi, Irene D., Starc, Thomas J.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.02.2023
• Subjects: Abnormalities; Adolescent; Age; Asthma; Biomarkers; Brain natriuretic peptide; Cardiomyopathy; Child; Children; Cohort Studies; Comorbidity; COVID-19; COVID-19 - epidemiology; Diabetes; Echocardiography; Electronic health records; Emergency medical care; Females; Heart; Hispanic Americans; Hospitals; Humans; Inflammation; Intensive Care; Kidney diseases; Medical records; Natriuretic Peptide, Brain; Original; Original Article; Pandemics; Patients; Pediatrics; Peptides; Polymerase chain reaction; Retrospective Studies; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Sickle cell disease; Snakes; Troponin; Troponin T; Ultrasonic imaging; Ventilators; Ventricle; Viral diseases; COVID-19; multi-system inflammatory syndrome in children; outcomes; cardiac
• ISSN: 1047-9511; 1467-1107
• DOI: 10.1017/S1047951122000397

Cardiac involvement associated with multi-system inflammatory syndrome in children has been extensively reported, but the prevalence of cardiac involvement in children with SARS-CoV-2 infection in the absence of inflammatory syndrome has not been well described. In this retrospective, single centre, cohort study, we describe the cardiac involvement found in this population and report on outcomes of patients with and without elevated cardiac biomarkers. Those with multi-system inflammatory syndrome in children, cardiomyopathy, or complex CHD were excluded. Inclusion criteriaz were met by 80 patients during the initial peak of the pandemic at our institution. High-sensitivity troponin T and/or N-terminal pro-brain type natriuretic peptide were measured in 27/80 (34%) patients and abnormalities were present in 5/27 (19%), all of whom had underlying comorbidities. Advanced respiratory support was required in all patients with elevated cardiac biomarkers. Electrocardiographic abnormalities were identified in 14/38 (37%) studies. Echocardiograms were performed on 7/80 patients, and none demonstrated left ventricular dysfunction. Larger studies to determine the true extent of cardiac involvement in children with COVID-19 would be useful to guide recommendations for standard workup and management.