Evaluation of cardiovascular manifestation of COVID-19 and their association with patients’ outcome in children who were admitted in the Tabriz children hospital from Farvardin 1399 till Khordad 1400

Abstract

Till now, multiple outbreaks have been reported by the Corona Virus Disease 2019(COVID). This virus can invaide different systems of oue body. One of the most important and even life-threatening system that can be invaded by this virus is cardiovascular system. Different investigations showed a wide spectrum of cardiovascular manifestation in different population. Some individuals may be asymptomatic and evidence of cardiovascular invasion can be find in physical exam and paraclinics while others can be affected more severly and even present with cardiogenic shock Moreover, period between virus invasion and cardiovascular presentation is quit different among individuals. The aim of this study was to investigate the different cardiovascular manifestation of COVID 19 and its equivocal and their assoscaition with their outcoms between pediatric patients. Methods: We performed a retrospective study on the pediatric patients under 18 years’ old who admitted to a pediatric referral center in the northwest Iran from March 2020 till June 2021 with the diagnosis COVID, MIS-C and KD-like. Demographic, clinical and para-clinical data were all gathered from medical records. Patients were evaluated at different interval regarding the type and severity of their illness but inorther to be comparable with each other only data of three times were included in this study: on admission, one week and three months later. Then all data were entered in to the SPSS software and suitable test were used. Significant p-value was 0.05. Results: We studied 151 patients with mean ± SD of 5.3± 4.1 years. About 60.9 % of the participants were male. The most common presentation on admission was fever. Respiratory, gastrointestinal, mucocutaneous and neurologic manifestation were seen in the 31.9%, 37.7 %, 36% and 4.6 % respectively. Cardiovascular sign and symptoms were seen in 2% of the patients. COVID, MIS-C and KD-like were diagnosed in 52.7%, 28.9% and 18.4% respectively. About 95.4% of the participants survived. Ten percent of the patients had underlying heart disease, however it had not a significant association with increasing mortality. Cardiovascular involvement was seen in about one third of the subjects; myocarditis (8.6%), pericarditis (7.3%) and coronary artery involvement (11.3%). For most of the patients, normal range of LVEF and valvar function were obtained in the follow up. No coronary abnormality was seen after three months. Having leukocytosis, lymphopenia, anemia, higher ESR and CRP level were all associated with the cardiac involvement. Those who received ASA had less mortality rate.