BACKGROUND: Children with 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: Cross-sectional multicenter study including all diagnosis of KD, myocarditis and multisystem inflammatory syndrome in children (MIS-C) from February to April,2020. KD patients were compared to those diagnosed before the epidemic.RESULTS: KD: 8 patients (6/8 boys, all negative for SARS-CoV-2); complete presentation in 5/8; 7/8 IVIG-responders; 3/8 showed transient coronary lesions (CALs).MYOCARDITIS: one 5-year-old girl negative for SARS-CoV-2, positive for Parvovirus B19. She responded to IVIG.MIS-C: 4 SARS-CoV-2 positive boys (3 patients with positive swab and serology, 1 patient with negative swab and positive serology). Three presented myocardial dysfunction and pericardial effusion, one 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 to 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 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.

Fabi, M., Filice, E., Andreozzi, L., Conti, F., Gabrielli, L., Balducci, A., et al. (2021). Spectrum of cardiovascular diseases in children during high peak COVID-19 period infection in Northern Italy: is there a link?. JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY, 10(6), 714-721 [10.1093/jpids/piaa162].

Spectrum of cardiovascular diseases in children during high peak COVID-19 period infection in Northern Italy: is there a link?

Fabi, Marianna
Primo
;
Filice, Emanuele
Secondo
;
Andreozzi, Laura;Conti, Francesca;Balducci, Anna;Corinaldesi, Elena;Lazzarotto, Tiziana;Pession, Andrea
Penultimo
;
Lanari, Marcello
Ultimo
2021

Abstract

BACKGROUND: Children with 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: Cross-sectional multicenter study including all diagnosis of KD, myocarditis and multisystem inflammatory syndrome in children (MIS-C) from February to April,2020. KD patients were compared to those diagnosed before the epidemic.RESULTS: KD: 8 patients (6/8 boys, all negative for SARS-CoV-2); complete presentation in 5/8; 7/8 IVIG-responders; 3/8 showed transient coronary lesions (CALs).MYOCARDITIS: one 5-year-old girl negative for SARS-CoV-2, positive for Parvovirus B19. She responded to IVIG.MIS-C: 4 SARS-CoV-2 positive boys (3 patients with positive swab and serology, 1 patient with negative swab and positive serology). Three presented myocardial dysfunction and pericardial effusion, one 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 to 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 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.
2021
Fabi, M., Filice, E., Andreozzi, L., Conti, F., Gabrielli, L., Balducci, A., et al. (2021). Spectrum of cardiovascular diseases in children during high peak COVID-19 period infection in Northern Italy: is there a link?. JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY, 10(6), 714-721 [10.1093/jpids/piaa162].
Fabi, Marianna; Filice, Emanuele; Andreozzi, Laura; Conti, Francesca; Gabrielli, Liliana; Balducci, Anna; Vergine, Gianluca; Cicero Md, Cristina; Iughetti, Lorenzo; Guerzoni, Maria Elena; Corinaldesi, Elena; Lazzarotto, Tiziana; Pession, Andrea; Lanari, Marcello
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/804985
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