cardiac involvement in covid-19 pediatric patients during the first year of pandemic

Background :the coronavirus disease 2019 (covid-19) is induced by severe acute respiratory syndrome caused by severe acute respiratory syndrome coronavirus 2 (sars-cov-2). the cardiac complications related to covid-19 include myocardial dysfunction, coronary artery involvement, and arrhythmias. objectives :this study was designed to evaluate the clinical manifestations, laboratory data, and cardiovascular involvement in hospitalized children with covid-19. methods :in this cross-sectional study, all children diagnosed with covid-19 at aliasghar children's hospital, tehran, during the first year of the covid-19 pandemic (from march 2020 to march 2021) were included. based on the diagnosis method — polymerase chain reaction (pcr) positive, chest computed tomography (ct) positive, or both — children were divided into three groups: the pcr, ct, and pcr+ct positive. clinical symptoms and vital signs at admission, hospitalization duration in the ward and intensive care unit (icu), electrocardiographic (ekg), and echocardiographic results were recorded. results :altogether, 47 patients were included, who were positive in covid-19 pcr in 18, ct in 17, and pcr+ct in 12 patients. the mean hospitalization duration was 9.4 ± 5.43 days. the most common clinical symptoms were constitutional, respiratory, and gastrointestinal complaints. respiratory rate and temperature decreased significantly at discharge in relation to admission time (p < 0.001). prolonged qt correction (qtc) was seen in two patients, and one patient had st elevation. in 5 patients, the left main coronary artery (lmca) was dilated (z-score > 2). various degrees of tricuspid regurgitation in 70.97% and mitral regurgitation in 29.03% of patients were determined, the latter of which was significantly more common among the pcr+ct group (p = 0.03). conclusions :although covid-19 in children may have a less grave presentation than in adults, it could lead to ekg abnormalities, coronary artery dilation, and degrees of tricuspid and mitral valve regurgitation.