Abstract
BackgroundCardiac evaluations, including cardiovascular magnetic resonance (CMR) imaging and biomarker results, are needed in children during mid-term recovery after infection with SARS-CoV-2. The incidence of CMR abnormalities 1–3 months after recovery is over 50% in older adults and has ranged between 1 and 15% in college athletes. Abnormal cardiac biomarkers are common in adults, even during recovery.MethodsWe performed CMR imaging in a prospectively-recruited pediatric cohort recovered from COVID-19 and multisystem inflammatory syndrome in children (MIS-C). We obtained CMR data and serum biomarkers. We compared these results to age-matched control patients, imaged prior to the SARS-CoV-2 pandemic.ResultsCMR was performed in 17 children (13.9 years, all ≤ 18 years) and 29 age-matched control patients without SARS-CoV-2 infection. Cases were recruited with symptomatic COVID-19 (11/17, 65%) or MIS-C (6/17, 35%) and studied an average of 2 months after diagnosis. All COVID-19 patients had been symptomatic with fever (73%), vomiting/diarrhea (64%), or breathing difficulty (55%) during infection. Left ventricular and right ventricular ejection fractions were indistinguishable between cases and controls (p = 0.66 and 0.70, respectively). Mean native global T1, global T2 values and segmental T2 maximum values were also not statistically different from control patients (p ≥ 0.06 for each). NT-proBNP and troponin levels were normal in all children.ConclusionsChildren prospectively recruited following SARS-CoV-2 infection had normal CMR and cardiac biomarker evaluations during mid-term recovery. Trial Registration Not applicable.
Highlights
Cardiac evaluations, including cardiovascular magnetic resonance (CMR) imaging and biomarker results, are needed in children during mid-term recovery after infection with SARS-CoV-2
Epidemiologic evidence gathered during the Coronavirus Disease 2019 (COVID-19) pandemic demonstrates that children infected with SARS-CoV-2 are relatively spared from severe disease compared to adults [1]
Abnormal serum troponin was present in 4 young adults with negative CMR in the retrospective review [5] and cardiac serum biomarkers have remained elevated in a quarter of asymptomatic adults during recovery [2, 3]
Summary
Cardiac evaluations, including cardiovascular magnetic resonance (CMR) imaging and biomarker results, are needed in children during mid-term recovery after infection with SARS-CoV-2. The incidence of CMR abnormalities 1–3 months after recovery is over 50% in older adults and has ranged between 1 and 15% in college athletes. A retrospective evaluation of 145 competitive athletes between 17 and 23 years of age demonstrated only a 1.4% incidence of abnormal CMR imaging during recovery [5]. These findings have been accompanied by abnormal serum biomarkers. Abnormal serum troponin was present in 4 young adults with negative CMR in the retrospective review [5] and cardiac serum biomarkers have remained elevated in a quarter of asymptomatic adults during recovery [2, 3]
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