Heart Disease Associated with COVID-19 in Children

Abstract

Introduction: Heart disease in children associated with COVID-19 is described during acute infection or in the context of the Multisystem inflammatory syndrome in children (MIS-C), and in patients with and without previous heart disease. It has different manifestations: asymptomatic, with alterations in complementary tests (elevated troponins, arrhythmias, imaging changes), up to severe forms: myocardial infarction, heart failure, cardiogenic shock, sudden death. We report a schoolgirl who had severe COVID-19, with cardiac, digestive, and respiratory manifestations. Clinical case: 10-year-old girl, carrier of disabling chronic disease. In the course of severe COVID-19, she added shock and respiratory failure, elevated inflammatory markers, increased troponins, and dilated cardiac cavities, with functional compromise of the left ventricle. She received non-invasive ventilatory assistance, antibiotics, and systemic corticosteroids. Cardiac manifestations reversed, with a decrease in inflammatory parameters. Discussion: The heart is frequently affected in COVID-19. Cardiac injury may be due to: viral replication, systemic inflammatory response, respiratory failure, or myocardial stress. The severity will depend on the extent of the damage and the inflammatory response. Cardiac involvement is more common in those who meet MIS-C criteria. Most recover cardiac function. The case report contributes to the knowledge of SARS-CoV-2 infection, and the severe forms of presentation with cardiac involvement in children highlight the need to advance in primary prevention by vaccines in the pediatric population.