Children's heart and COVID-19: Up-to-date evidence in the form of a systematic review

Eur J Pediatr. 2020 Jul;179(7):1079-1087. doi: 10.1007/s00431-020-03699-0. Epub 2020 May 30.

Abstract

The new coronavirus disease outbreak in 2019 (COVID-19) represents a dramatic challenge for healthcare systems worldwide. As to viral tropism, lungs are not the only COVID-19 target but also the heart may be involved in a not negligible percentage of the infected patients. Myocarditis-related cardiac dysfunction and potentially life-threatening arrhythmias are the main aftermaths. A few studies showed that myocardial injury in adult patients is often linked with a fatal outcome. Conversely, scientific evidence in children is sparse, although several reports were published with the description of a cardiac involvement in COVID-19 paediatric patients. In these young subjects, a background of surgically treated congenital heart disease seems to be a predisposing factor.Conclusion: This systematic review is aimed at summarizing all COVID-19 cases with a cardiac involvement published in paediatric age and trying to explain the underlying mechanisms responsible for COVID-19-related myocardial damage.What is Known:• Coronaviruses proved to be able to jump from animals to humans.• The outbreak of COVID-19 started from China (Dec 2019) and became pandemic.What is New:• Even in childhood, COVID-19 is not without the risk of cardiac involvement.• Myocarditis, heart failure, and arrhythmias are among the possible manifestations.

Keywords: COVID-19; Cardiovascular; Coronavirus; Heart; Myocarditis; Severe respiratory distress syndrome.

Publication types

  • Systematic Review

MeSH terms

  • Betacoronavirus* / isolation & purification
  • COVID-19
  • COVID-19 Testing
  • Child
  • Clinical Laboratory Techniques
  • Coronavirus Infections / complications*
  • Coronavirus Infections / diagnosis
  • Heart Diseases / diagnosis
  • Heart Diseases / therapy
  • Heart Diseases / virology*
  • Humans
  • Pandemics
  • Pneumonia, Viral / complications*
  • Pneumonia, Viral / diagnosis
  • Prognosis
  • Risk Factors
  • SARS-CoV-2