Volume 2, Issue 1 (Winter 2021)
J Vessel Circ 2021, 2(1): 43-48 |
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Zargar S, Ghandi Y, Mousavi Hasanzadeh M. Myocarditis, a Life-Threatening Presentation of COVID-19 in a 4-Month-Old Infant. J Vessel Circ 2021; 2 (1) :43-48
URL: http://jvessels.muq.ac.ir/article-1-63-en.html
URL: http://jvessels.muq.ac.ir/article-1-63-en.html
1- Department of Pediatric, School of Medicine, Arak University of Medical Sciences, Arak, Iran., Amir Kabir Hospital
2- Department of Pediatric Cardiology, Amir Kabir Hospital, Arak University of Medical Sciences, Arak, Iran., Amir Kabir Hospital
2- Department of Pediatric Cardiology, Amir Kabir Hospital, Arak University of Medical Sciences, Arak, Iran., Amir Kabir Hospital
Abstract: (1366 Views)
Background and Aim: Significant cardiac sequelae may be one of the main causes of death in COVID-19 patients; however, very few reports are available that address these complications and their treatment strategies in children.
Case Presentation: A 4-month-old male infant was admitted to the pediatric intensive care unit with sudden tachycardia, tachypnea, and low oxygen saturation after surgery. Laboratory tests and echocardiography revealed elevated troponin I levels and myocardial dyskinesia with
decreased Left Ventricular Ejection Fraction (LVEF= 50%) and pulmonary hypertension (30 mm Hg) consistent with the cardiac injury. Despite his normal chest x-ray, the chest CT scan disclosed ground-glass opacities in the periphery of the left lower lobe indicative of viral infection. The
patient fulfilled the diagnostic criteria of the “Chinese expert consensus statement for clinical myocarditis”. The viral test for COVID-19 obtained on the first day of admission was found positive a few days later. The patient successfully recovered clinically after receiving anti-failure therapy and IVIG. Trop I level reduced to 0.10 g/L, and the LVEF eventually recovered to 68%.
Conclusion: COVID-19 patients may develop severe cardiac complications such as myocarditis and heart failure. Myocarditis in this patient was treated without antiviral drugs and only with supportive therapies.
Case Presentation: A 4-month-old male infant was admitted to the pediatric intensive care unit with sudden tachycardia, tachypnea, and low oxygen saturation after surgery. Laboratory tests and echocardiography revealed elevated troponin I levels and myocardial dyskinesia with
decreased Left Ventricular Ejection Fraction (LVEF= 50%) and pulmonary hypertension (30 mm Hg) consistent with the cardiac injury. Despite his normal chest x-ray, the chest CT scan disclosed ground-glass opacities in the periphery of the left lower lobe indicative of viral infection. The
patient fulfilled the diagnostic criteria of the “Chinese expert consensus statement for clinical myocarditis”. The viral test for COVID-19 obtained on the first day of admission was found positive a few days later. The patient successfully recovered clinically after receiving anti-failure therapy and IVIG. Trop I level reduced to 0.10 g/L, and the LVEF eventually recovered to 68%.
Conclusion: COVID-19 patients may develop severe cardiac complications such as myocarditis and heart failure. Myocarditis in this patient was treated without antiviral drugs and only with supportive therapies.
Keywords: Coronavirus infections, COVID-19, Infantile cardiomyopathy, Ventricular dysfunction, Myocarditis, SARSCoV-2
Type of Study: case report |
Subject:
cardiovascular diseases
Received: 2021/03/23 | Accepted: 2021/06/30 | Published: 2021/03/30
Received: 2021/03/23 | Accepted: 2021/06/30 | Published: 2021/03/30
References
1. [1] Netland J, Meyerholz DK, Moore S, Cassell M, Perlman S. Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol. 2008; 82(15):7264-75. [DOI:10.1128/JVI.00737-08] [PMID] [PMCID] [DOI:10.1128/JVI.00737-08]
2. [2] Tan W, Aboulhosn J. The cardiovascular burden of coronavirus disease 2019 (COVID-19) with a focus on congenital heart disease. Int J Cardiol. 2020; 309:70-7. [DOI:10.1016/j.ijcard.2020.03.063] [PMID] [PMCID] [DOI:10.1016/j.ijcard.2020.03.063]
3. [3] Huang Y, Yang R, Xu Y, Gong P. Clinical characteristics of 36 non-survivors with COVID-19 in Wuhan, China. MedRxiv. 2020; Preprint. [DOI:10.1101/2020.02.27.20029009] [DOI:10.1101/2020.02.27.20029009]
4. [4] Cao M, Zhang D, Wang Y, Lu Y, Zhu X, Li Y, et al. Clinical features of patients infected with the 2019 novel Coronavirus (COVID-19) in Shanghai, China. MedRxiv. 2020;2020.03.04.20030395. [DOI:10.1101/2020.03.04.20030395] [PMID] [PMCID] [DOI:10.1101/2020.03.04.20030395]
5. [5] Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel Coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020; 323(11):1061-9. [DOI:10.1001/jama.2020.1585] [PMID] [PMCID] [DOI:10.1001/jama.2020.1585]
6. [6] Wu Z, McGoogan JM. Characteristics of and important lessons from the Coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese Center for disease control and prevention. JAMA. 2020; 323(13):1239-42. [DOI:10.1001/jama.2020.2648] [PMID] [DOI:10.1001/jama.2020.2648]
7. [7] Dong Y, Mo X, Hu Y, Qi X, Jiang F, Jiang Z, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 Coronavirus disease in China. Pediatrics. 2020 ; 145(6):e20200702. [DOI:10.1542/peds.2020-0702] [PMID] [DOI:10.1542/peds.2020-0702]
8. [8] Rodriguez-Gonzalez M, Castellano-Martinez A, Cascales- Poyatos HM, Perez-Reviriego AA. Cardiovascular impact of COVID-19 with a focus on children: A systematic review. World J Clin Cases. 2020; 8(21):5250-83. [DOI:10.12998/wjcc.v8.i21.5250] [PMID] [PMCID] [DOI:10.12998/wjcc.v8.i21.5250]
9. [9] Kohli U, Lodha R. Cardiac involvement in children with COVID-19. Indian Pediatr. 2020; 57(10):936-9. [DOI:10.1007/s13312-020-1998-0] [PMID] [PMCID] [DOI:10.1007/s13312-020-1998-0]
10. [10] Khodadadi J, Sharifipour E, Ghadir MR, Bozorgqomi N, Shams S, Eshraghi A, et al . Potential cardiomyopathy in a mortality case with COVID-19: A case report. J Vessel Circ. 2020; 1(3):1-8. http://jvessels.muq.ac.ir/article-1-46-en.html
11. [11] Hasan A, Mehmood N, Fergie J. Coronavirus disease (COVID-19) and pediatric patients: A review of epidemiology, symptomatology, laboratory and imaging results to guide the development of a management algorithm. Cureus. 2020;12(3):e7485. [DOI:10.7759/cureus.7485] [DOI:10.7759/cureus.7485]
12. [12] Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020; 8(4):420-2. [DOI:10.1016/S2213-2600(20)30076-X] [13] Wang D, Li S, Jiang J, Yan J, Zhao C, Wang Y, et al. Chinese society of cardiology expert consensus statement on the diagnosis and treatment of adult fulminant myocarditis. Sci China Life Sci. 2019; 62(2):187-202. [DOI:10.1007/BF02879672] [PMID] [DOI:10.1007/BF02879672]
13. [14] Dolhnikoff M, Ferreira Ferranti J, de Almeida Monteiro RA, Duarte-Neto AN, Soares Gomes-Gouvêa M, Viu Degaspare N, et al. SARS-CoV-2 in cardiac tissue of a child with COVID-19-related multisystem inflammatory syndrome. Lancet Child Adolesc Health. 2020; 4(10):790-4. [DOI:10.1016/S2352- 4642(20)30257-1] [PMID] [PMCID] [DOI:10.1016/S2352-4642(20)30257-1]
14. [15] Sanna G, Serrau G, Bassareo PP, Neroni P, Fanos V, Marcialis MA. Children's heart and COVID-19: Up-to-date evidence in the form of a systematic review. Eur J Pediatr. 2020;179(7):1079-87. [DOI:10.1007/s00431-020-03699-0] [PMID][PMCID] [DOI:10.1007/s00431-020-03699-0]
15. [16] Cui Y, Tian M, Huang D, Wang X, Huang Y, Fan L, et al. A 55-day-old female infant infected with 2019 novel Coronavirus disease: Presenting with pneumonia, liver injury, and heart damage. J Infect Dis. 2020; 221(11):1775-81.[DOI:10.1093/infdis/jiaa113] [PMID] [PMCID] [DOI:10.1093/infdis/jiaa113]
16. [17] Del Barba P, Canarutto D, Sala E, Frontino G, Guarneri MP, Camesasca C, et al. COVID-19 cardiac involvement in a 38-day old infant. Pediatr Pulmonol. 2020; 55(8):1879-81. [DOI:10.1002/ppul.24895] [PMID] [PMCID] [DOI:10.1002/ppul.24895]
17. [18] Mehrabi S, Safaei M, Ghandi Y, Bahrami M. Chest CT features in pediatric patients with COVID-19 infection: A brief review article. International Journal of Pediatrics. 2021;9(4):13421-7. [DOI:10.22038/IJP.2020.48307.3891]
18. [19] Mansurian M, Ghandi Y, Habibi D, Mehrabi S. COVID-19 infection in children: A systematic review and meta-analysis of clinical features and laboratory findings. Archives de Pédiatrie. 2021; 28(3):242-8. https://www.sciencedirect.com/science/article/pii/S0929693X21000014 [DOI:10.1016/j.arcped.2020.12.008]
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