Abstract
Coronavirus disease 2019 (COVID-19) is a global pandemic caused by SARS-CoV-2 virus. As of the 30th of September 2020, around 34,000,000 cases have been reported globally. Pediatrics with underlying congenital heart disease represent a small yet a critical proportion of these patients. In general, the majority of infected children experience mild to moderate disease with significant interindividual variability in laboratory and radiographic findings. Nevertheless, in healthy children with COVID-19, cardiac involvement has been documented and is attributed to various causes. Myocarditis, arrhythmias, cardiogenic shock, and serious multisystem inflammatory syndrome in children are all encountered. Since COVID-19 is a recent novel disease and based on previous experience with respiratory infections, children with underlying congenital heart disease should be given special attention. To date, little data is available about COVID-19 presentation, complications, and appropriate treatment in this population. However, variable and inconsistent disease presentation and severity have been observed. This paper discusses COVID-19 course of illness in pediatric population with a special emphasis on the cardiac manifestations of the disease in healthy population and also on the disease course in congenital heart disease patients in particular.
Highlights
Coronaviruses (CoVs) are enveloped single stranded RNA viruses that belong to the Coronaviridae family [1]
The majority had normal lymphocyte count [34]; lymphocytopenia was reported in 2 studies accounting for 3 and 3.5% of the population [25, 34]
Published data describing the radiographic findings in pediatric patients with COVID-19 is scarce
Summary
Coronaviruses (CoVs) are enveloped single stranded RNA viruses that belong to the Coronaviridae family [1]. It greatly hinges on the type and severity of CHD, where in the milder diseases survival to adulthood reached almost 98% [13] These children remain at remarkable risk for increased morbidity and mortality from lower respiratory tract infections [14]. Reported disease severity of infected children range from asymptomatic to mild, moderate, severe and critically ill cases (Table 1) depicts the clinical features of cases classified with different disease severity. China’s first critically ill pediatric case displayed only gastrointestinal symptoms in early disease state and progressed rapidly to acute respiratory distress syndrome, septic shock, and renal failure [24]. Of the 171 cases in the Chinese study, 3 patients required pediatric intensive care unit (PICU) admission, and all had underlying medical illness (leukemia on chemotherapy, hydronephrosis and intussusception). Ill Rapidly progressing to acute respiratory symptoms, respiratory failure and end organ damage such as heart failure, shock, acute kidney injury, liver injury, encephalopathy, coagulopathy, or myocardial damage
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