Cardiac Manifestations in COVID-19 Patients: A Focus on the Pediatric Population

Table 1

Cardiac-related clinical descriptions of pediatric patients with COVID-19.

Reference	Number of cases	Country	Age	Sex	Physical exam	ECG	Echo	Elevated labs	Imaging	Treatment	Outcome
[19]	1	China	55 d	F	Tachycardia, respiratory distress, pharyngeal hyperemia, cough	NA	NA	Troponin, CK-MB, procalcitonin	Ground-glass opacities, pneumonia	IVIG, inhaled interferon alfa 1b, glutathione, Chinese lotus qingwen	Survived
[20]	1	China	13 m	M	Cough, crackles	NA	Heart failure	CRP, creatinine kinase, D-dimer, IL6, interferon-gamma,	Multiple patch-like shadows, pneumonia	Virazole, oseltamivir, interferon, IVIG, steroids, oxygen therapy, mechanical ventilation	Survived
[21]	9	China	11 m-10 y	3M	Productive cough	NA	NA	CK-MB, Pro-BNP, D-dimer	Pulmonary consolidation, ground-glass opacities	Inhaled interferon, ribavirin, lopinaviritonavir	NA
[17]	13/2135	China	0–18 y	12M	NA	NA	Heart failure	NA	NA	NA	NA
[22]	3	USA	6–13 y	2M	Tachycardia, tachypnea, hypotension, systolic murmur, dyspnea	Sinus tachycardia	Depressed function, MR, flow reversal in descending aorta, pericardial effusion	Procalcitonin, D-dimer, fibrinogen, troponin, CRP, LDH	NA	IL6 inhibitor, IVIG, hydroxychloroquine	Survived
[23]	21	France	3–17 y	9M	Cough	QT prolongation, ST-segment elevation, ventricular arrhythmia	Coronary artery dilatation, myocarditis, pleural effusion, depressed ejection fraction	CRP, procalcitonin, IL6, Pro-BNP, D-dimer	Local patchy shadows, ground-glass opacities, interstitial abnormalities	IVIG, aspirin, corticosteroids, inotropes, oxygen support, mechanical ventilation	Survived
[24]	1	USA	6 y	F	Syncope, respiratory distress, hypotension	Junctional rhythm	Depressed ejection function, MR	CRP, procalcitonin, Pro-BNP, D-dimer	Diffuse patchy infiltrates	Aspirin, IVIG, inotropic support, oxygen support, ECMO	Survived
[25]	99	USA	0–20 y	53M	Hypotension, cough, shortness of breath, wheezing	NA	Ventricular dysfunction, pericardial effusion, CAA	Troponin, Pro-BNP, D-dimer, CRP, fibrinogen, ferritin, ESR	Opacities, pleural effusion	Corticosteroids, IVIG, oxygen support, inotropic support, ECMO	2/99 died
[26]	186	USA	0–20 y	115M	NA	NA	Coronary artery dilatation, CAA, depressed EF, pericardial effusion	Pro-BNP, troponin, D-dimer, fibrinogen, INR	NA	IL6 inhibitors, IL1Ra inhibitor, IVIG, corticosteroids mechanical ventilation, ECMO, vasopressor support, oxygen support	4/186 died
[27]	15	USA	3–20 y	11M	Cough, dyspnea, chest pain, tachycardia, hypotension	Ventricular tachycardia, and ectopy, diffuse ST elevation	Depressed LV/biventricular function, coronary artery ectasia and dilatation, cardiogenic shock	Troponin, Pro-BNP, fibrinogen, CRP, D-dimer, procalcitonin, IL6, IL8, TNF alfa	Ground-glass opacities, pleural effusion	IVIG, steroids, anakinra, remdesivir, inotropic support, anticoagulation, mechanical ventilation, ECMO, intraaortic balloon pump, tocilizumab, COVID-19 convalescent plasma,	1/15 died
[28]	5	France and Switzerland	2–16 y	18M	Respiratory distress, chest pain	Ventricular arrhythmia, nonspecific ST elevation	Cardiogenic shock, LV dysfunction and hypokinesis, coronary artery dilatation, pericardial effusion	Troponin, creatinine kinase, Pro-BNP, D-dimer, CRP, procalcitonin, IL6	NA	Inotropic support, mechanical ventilation, ECMO, IVIG, steroids, anakinra	Survival
[29]	4	USA	3–20 y	3M	Tachycardia	Low voltage nonspecific T-wave changes, right axis deviation, ST-segment elevation, QTc prolongation	Myocarditis, MR, depressed LV and RV functions, pericardial effusion	CRP, ferritin, troponin, pro-BPN, D-dimer, ferritin, fibrinogen	NA	IVIG, anticoagulation, tocilizumab, convalescent plasma, mechanical ventilation, ECMO	1/4 died
[30]	1	USA	6 m	F	Tachycardia, tachypnea	NA	Normal	ESR, CRP	Opacities	Aspirin, IVIG	Survived
[31]	156	France	5–11 y	77M	NA	NA	Myocarditis	NA	NA	Mechanical ventilation, inotropic support	1/156 died