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Review
. 2021 Jan;42(1):19-35.
doi: 10.1007/s00246-020-02476-y. Epub 2020 Oct 4.

Role of a Pediatric Cardiologist in the COVID-19 Pandemic

Talha Niaz  1 , Kyle Hope  2 , Michael Fremed  3 , Nilanjana Misra  4 , Carrie Altman  2 , Julie Glickstein  3 , Joan Sanchez-de-Toledo  5 , Alain Fraisse  6 , Jacob Miller  7 , Christopher Snyder  8 , Jonathan N Johnson  1 , Devyani Chowdhury  9
Affiliations
Review

Role of a Pediatric Cardiologist in the COVID-19 Pandemic

Talha Niaz et al. Pediatr Cardiol. 2021 Jan.

Abstract

Coronavirus disease 2019 (COVID-19) has affected patients across all age groups, with a wide range of illness severity from asymptomatic carriers to severe multi-organ dysfunction and death. Although early reports have shown that younger age groups experience less severe disease than older adults, our understanding of this phenomenon is in continuous evolution. Recently, a severe multisystem inflammatory syndrome in children (MIS-C), with active or recent COVID-19 infection, has been increasingly reported. Children with MIS-C may demonstrate signs and symptoms of Kawasaki disease, but also have some distinct differences. These children have more frequent and severe gastrointestinal symptoms and are more likely to present with a shock-like presentation. Moreover, they often present with cardiovascular involvement including myocardial dysfunction, valvulitis, and coronary artery dilation or aneurysms. Here, we present a review of the literature and summary of our current understanding of cardiovascular involvement in children with COVID-19 or MIS-C and identifying the role of a pediatric cardiologist in caring for these patients.

Keywords: COVID-19; Cardiovascular; MIS-C; Pediatric.

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Conflict of interest statement

The authors have indicated they have no potential conflicts of interest to disclose. Authors have indicated they have no financial relationships relevant to this article to disclose.

Figures

Fig. 1
Fig. 1
Approach in children with COVID-19 and MIS-C with red flags for pediatric cardiology referral
Fig. 2
Fig. 2
Electrocardiographic abnormalities in children with COVID-19 and MIS-C. a Low-voltage QRS complex in a patient with myocarditis. b Complete heart block in a patient with myocarditis. c ST segment changes in anterior leads suggestive of anterior infarction in a patient with giant coronary artery aneurysms and thrombosis
Fig. 3
Fig. 3
Echocardiographic abnormalities in children with COVID-19 and MIS-C. a Parasternal short axis view at the level of aortic valve demonstrating diffuse dilation of right coronary artery (RCA) and coronary artery walls are echogenic. b Apical 4 chamber view demonstrating mitral valve regurgitation. c Parasternal short axis view at the level of mitral valve showing tiny posterior pericardial effusion in a patient with myocarditis. d M-mode demonstrating decreased systolic function. e Apical 4 chamber view demonstrating severe left ventricular (LV) dilation due to myocardial dysfunction
See this image and copyright information in PMC

References

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Supplementary concepts