Cardiac Abnormalities Seen in Pediatric Patients During the SARS-CoV2 Pandemic: An International Experience
Por:
Clark BC, Sanchez deToledo J, Bautista Rodríguez C, Choueiter N, Lara D, Kang H, Mohsin S, Fraisse A, César-Díaz S, Sattar Shaikh A, Escobar-Diaz MC, Hsu DT, Randanne PC, Aslam N, Kleinmahon J, Lamour JM, Johnson JN, Sarquella-Brugada G and Chowdhury D
Publicada:
3 nov 2020
Ahead of Print:
22 sep 2020
Categoría:
Cardiology and cardiovascular medicine
Resumen:
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.
Filiaciones:
Clark BC:
Division of Cardiology Children's Hospital at Montefiore Department of Pediatrics Albert Einstein College of Medicine Bronx NY
Sanchez deToledo J:
Department of Cardiology Hospital Sant Joan de Deu Barcelona Spain
Department of Critical Care Medicine Children's Hospital of Pittsburgh Pittsburgh PA
Bautista Rodríguez C:
Paediatric Cardiology Services Royal Brompton and Harefield Hospitals Trust National Heart and Lung Institute Imperial College London UK
Choueiter N:
Division of Cardiology Children's Hospital at Montefiore Department of Pediatrics Albert Einstein College of Medicine Bronx NY
Lara D:
Division of Cardiology Ochsner Health New Orleans LA
Kang H:
Paediatric Cardiology Services Royal Brompton and Harefield Hospitals Trust National Heart and Lung Institute Imperial College London UK
Mohsin S:
Section of Pediatric Cardiology Department of Pediatric and Child Health Aga Khan University Hospital Karachi Pakistan
Fraisse A:
Paediatric Cardiology Services Royal Brompton and Harefield Hospitals Trust National Heart and Lung Institute Imperial College London UK
César-Díaz S:
Department of Cardiology Hospital Sant Joan de Deu Barcelona Spain
Sattar Shaikh A:
Paediatric Cardiology National Institute of Cardiovascular Diseases Karachi Pakistan
Escobar-Diaz MC:
Department of Cardiology Hospital Sant Joan de Deu Barcelona Spain
Hsu DT:
Division of Cardiology Children's Hospital at Montefiore Department of Pediatrics Albert Einstein College of Medicine Bronx NY
Randanne PC:
Department of Cardiology Hospital Sant Joan de Deu Barcelona Spain
Aslam N:
Section of Pediatric Cardiology Department of Pediatric and Child Health Aga Khan University Hospital Karachi Pakistan
Kleinmahon J:
Division of Cardiology Ochsner Health New Orleans LA
Lamour JM:
Division of Cardiology Children's Hospital at Montefiore Department of Pediatrics Albert Einstein College of Medicine Bronx NY
Johnson JN:
Division of Cardiology Mayo Clinic Children's Center Rochester MN
Sarquella-Brugada G:
Department of Cardiology Hospital Sant Joan de Deu Barcelona Spain
Chowdhury D:
Cardiology Care for Children Lancaster PA
Green Submitted, gold
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