Presentation and Outcome of Congenital Heart Disease During Covid-19 Pandemic: A Review

Abstract

Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-COV₂) infection is a rapid evolving pandemic with multiple peaks of outbreak and substantial mortality worldwide. It has been proposed that infants are more vulnerable to SARS-COV-2 infection. On the other hand, children with COVID-19 have generally milder disease compared to infected adults and more often presented with gastrointestinal symptoms compared to respiratory ones. Multisystem inflammatory syndrome in children (MIS-c) is an ominous demonstration of COVID-19 with cardiac involvement and mortality rate <2%. From cardiovascular point of view, wide spectrum of manifestations including subclinical myocardial injury, myocarditis, stress cardiomyopathies, cardiac arrhythmias, pulmonary thromboembolism and thrombus formation in cardiac chambers and vascular bed has been reported in COVID-19 disease. Congenital heart disease (CHD), assumed as the most prevalent form of congenital disease. Advances in medical and surgical treatments for CHD have led to more alive patients with underlying heart disease secondary to congenital defects. These group of pediatric patients are prone to heart failure, arrhythmia and embolic events. In this narrative review, we intended to evaluate the cardiovascular and pediatric presentations of COVID-19 as well as the manifestation and outcomes of SARS-CoV-2 infection on pediatric patients with CHD.