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Spectrum of Cardiovascular Diseases in Children During High Peak Coronavirus Disease 2019 Period Infection in Northern Italy: Is There a Link?
- Source :
- Journal of the Pediatric Infectious Diseases Society
- Publication Year :
- 2020
-
Abstract
- Background Children with coronavirus disease-2019 (COVID-19) have a milder clinical course than adults. We describe the spectrum of cardiovascular manifestations during a COVID-19 outbreak in Emilia-Romagna, Italy. Methods A cross-sectional multicenter study was performed, including all patients diagnosed with Kawasaki disease (KD), myocarditis, and multisystem inflammatory syndrome in children (MIS-C) from February to April 2020. KD patients were compared with those diagnosed before the epidemic. Results KD: 8 patients (6/8 boys, all negative for severe acute respiratory syndrome coronavirus-2 [SARS-CoV-2]): complete presentation in 5/8, 7/8 immunoglobulin (IVIG) responders, and 3/8 showed transient coronary lesions (CALs). Myocarditis: one 5-year-old girl negative for SARS-CoV-2 and positive for parvovirus B19. She responded to IVIG. MIS-C: 4 SARS-CoV-2-positive boys (3 patients with positive swab and serology and 1 patient with negative swab and positive serology): 3 presented myocardial dysfunction and pericardial effusion, and 1 developed multicoronary aneurysms and hyperinflammation; all responded to treatment. The fourth boy had mitral and aortic regurgitation that rapidly regressed after steroids. Conclusions KD, myocarditis, and MIS-C were distinguishable cardiovascular manifestations. KD did not show a more aggressive form compared with previous years: coronary involvement was frequent but always transient. MIS-C and myocarditis rapidly responded to treatment without cardiac sequelae despite high markers of myocardial injury at the onset, suggesting a myocardial depression due to systemic inflammation rather than focal necrosis. Evidence of actual or previous SARS-CoV-2 infection was documented only in patients with MIS-C.
- Subjects :
- Male
medicine.medical_specialty
Myocarditis
Adolescent
Multisystem Inflammatory Syndrome
030204 cardiovascular system & hematology
Systemic inflammation
Pericardial effusion
Serology
03 medical and health sciences
0302 clinical medicine
children
Internal medicine
medicine
Humans
030212 general & internal medicine
Pediatrics, Perinatology, and Child Health
Kawasaki Disease
Child
multisystem inflammatory syndrome
Kawasaki disease
biology
business.industry
Parvovirus
SARS-CoV-2
COVID-19
KDSS
myocarditis
Outbreak
General Medicine
medicine.disease
biology.organism_classification
Systemic Inflammatory Response Syndrome
Systemic inflammatory response syndrome
Infectious Diseases
Cross-Sectional Studies
AcademicSubjects/MED00290
Cardiovascular Diseases
Pediatrics, Perinatology and Child Health
Female
Original Article
medicine.symptom
business
AcademicSubjects/MED00670
Subjects
Details
- ISSN :
- 20487207
- Volume :
- 10
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- Journal of the Pediatric Infectious Diseases Society
- Accession number :
- edsair.doi.dedup.....ba8cfe8b2d04360eacb6ece93ac0b9ae