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Heart problems after COVID-19 are rare in children and young adults: www.kinderaerzte-im-netz.de

13.06.2022

Cardiac complications in children and young adults following COVID-19 or SARS-CoV-2 infection are rare and treatable. This is the result of a statement from the American Heart Association published in the journal Circulation.

The most recent data on which this opinion is based also shows that returning to sport and resuming strenuous physical activity after symptom resolution is safe. Additional screening should be considered in adolescents with more severe symptoms.
Opinion experts are calling for more research on this topic, including studies on the long-term effects of COVID-19 on the cardiovascular system in children and young adults. Extensive research by the expert group on the latest data revealed that children with congenital heart disease (heart disease or birth defects) have low rates of infection and complications from SARS-CoV-2, the virus that causes COVID-19.

“Two years since the start of the pandemic […] This publication summarizes what we know so far about COVID-19 in children, ”said group chairman Prof. Dr. Pei-Ni Jone, MD, FAHA, Director of 3D Echocardiography, Kawasaki Disease Clinic and Quality of Health. ‘Echocardiography at the Aurora Children’s Hospital Colorado. “We focused on the impact of this virus on people with congenital or other heart disease, as well as the latest data on the possible link of COVID-19 vaccines to heart complications in children and young adults. Although we know a lot, this topic it still requires a lot of work to understand the short- and long-term effects on children. “

Children generally develop mild symptoms

Analysis of the latest research shows that children generally develop mild symptoms when infected with SARS-CoV-2. In the United States, as of February 24, 2022, children accounted for 17.6% of all COVID-19 cases and about 0.1% of deaths from the virus. Additionally, young adults between the ages of 18 and 29 were responsible for 21.3% of cases and 0.8% of deaths from COVID-19. Studies suggest that some factors could explain why children may be less susceptible to severe COVID-19: 1) cells in the children’s body have fewer receptors to bind to the SARS-CoV-2 virus and 2) due to a different response to cytokines, the immune system may be less reactive in children than in adults. Because the adult immune system is trained by vaccines and viral infections.

Children with heart problems less susceptible to severe COVID-19 courses than children with genetic syndromes

While children with congenital heart defects have low rates of infection and mortality from SARS-CoV-2 infection, an underlying genetic syndrome such as trisomy 21 (also known as Down syndrome) appears to be associated with an increased risk of COVID-19. serious connected.

Rare cases of heart complications

Individual reports describe the following heart problems that have occurred in connection with Covid-19:

  • cardiogenic shock, in which a suddenly weakened heart cannot pump enough blood to meet the body’s needs;
  • myocarditis (inflammation of the heart muscle); pericarditis (inflammation of the pouch around the heart, a thin pouch-like structure that surrounds the heart);
  • and arrhythmias (irregular heartbeats).

Sudden cardiac death and death after intensive medical and life-support treatment were rarely observed in children with severe COVID-19 if the heart was compromised.

Since the onset of the COVID-19 pandemic, a new pediatric multisystem inflammatory syndrome (MIS-C) has been identified worldwide, with as many as half of the cases presenting with inflammation of the heart muscle or coronary arteries. In the first year of the pandemic, one in 3,164 children infected with SARS-CoV-2 contracted MIS-C.

Most children’s hearts heal well within 1-4 weeks of being diagnosed with MIS-C

Children who develop MIS-C have been given intravenous immunoglobulin (IVIG) alone or in dual therapy with infliximab or other immunomodulatory agents. Most of the children’s hearts recovered well within 1-4 weeks of MIS-C diagnosis. The risk of long-term complications and death from MIS-C is estimated at 1.4-1.9%.
You can resume sports after a mild illness if you are asymptomatic
For children and young adults with COVID-19, the return to sport and physical exertion has been a specifically studied and studied area. The latest data suggests that those who have had a mild or asymptomatic COVID-19 infection can safely return to sports after recovering from all symptoms. For adolescents who have developed severe illness or MIS-C, it makes sense to consider selective cardiovascular screenings such as an echocardiogram, blood tests for cardiac enzyme levels, and other heart function screenings before resuming exercise. publication.

Corona vaccination can reduce the risk of MIS-C

COVID-19 vaccines can prevent patients from contracting COVID-19 and reduce the risk of MIS-C in children aged 12 to 18 by 91%. Some have raised concerns about the risk of heart inflammation after vaccination with an mRNA vaccine. The data show that the benefits of vaccination outweigh the risk of potentially vaccine-associated myocarditis. For example, every 1 million doses of COVID-19 mRNA vaccines in males aged 12 to 29 years (the highest risk group for vaccine-associated myocarditis) would prevent approximately 11,000 cases of COVID-19, 560 hospitalizations and 6 deaths between 39 and 47 years one would expect cases of myocarditis. The FDA has granted emergency use authorization for the mRNA vaccine, manufactured by Pfizer-BioNTech, for children aged 5 and over, and has full approval for all ages 16 and older.

Viral infections are the most common cause of inflammation of the heart muscle (myocarditis) in children

According to data from the US Centers for Disease Control and Prevention (CDC), prior to the COVID-19 pandemic, approximately 1-2 children in every 100,000 in the United States were diagnosed with myocarditis each year. Children are more likely than adults to develop myocarditis due to a viral infection such as COVID-19.

Those: ScienceDaily, American Heart Association, Circulation

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