Covid and Pediatric Heart Diseases
Child Heart Health in the Covid-19 Pandemic
On March 11, 2019, the World Health Organization declared the disease associated with the Covid-19 virus as a pandemic, and since then, fatal results of the disease have been encountered all over the world, especially in adults.
What are the Disease Findings?
The disease can occur in a wide spectrum ranging from a clinical condition that does not show any symptoms in all age groups to a severe clinical condition that poses a life-threatening risk and causes the death of the patient. Less severe forms of the disease have also been described in children and young adults compared to older adults. The most important difference that draws attention in different age groups in childhood is that active or recent Covid-19 disease causes a life-threatening picture called severe inflammatory syndrome that affects the whole body.
What are the Risk Factors?
Potential risk factors for the development of heart disease and changing the course of the disease in children have been identified; Children with impaired immune system, obesity, being younger than 1 year old, having a chronic disease requiring medical treatment before, the presence of genetic diseases, and developmental delays are at high risk, and those with these risk factors should be closely monitored for the development of heart disease.
Which organ does Covid-19 disease affect in the Child Age Group?
Covid-19 disease in children especially affects the heart and veins; if the heart is affected; Inflammation of the heart muscle, heart failure, and inflammation of the coronary arteries, which are the nourishing vessels of the heart, are the most feared complications. In addition, a very severe clinical picture accompanied by the involvement of many organs associated with Covid-19 in pediatric age groups has also been defined, and this clinical picture can lead to clinical shock and loss of the patient. In the early stages of this picture, signs of respiratory system disease or digestive system findings such as nausea, vomiting, abdominal pain and diarrhea can often be detected. During this picture, many organs including the heart, neurological system, kidneys and body blood cells are involved in the disease. For this reason, when these symptoms are seen, it should be evaluated in terms of the presence of heart disease.
What are the signs and symptoms?
In the pediatric age group, in the case of Covid-19 disease affecting the heart, the first symptoms may vary according to the age of the child, but may include difficulty in breathing, chest pain, palpitations, high heart rate, and high respiratory rate. When these findings are observed, laboratory examinations where some blood tests are taken as well as tests such as EKG and ECO should be performed. During the typical course of the disease, cough, fever above 38°C, muscle aches, nasal congestion, difficulty in breathing, nausea, vomiting, diarrhea, fatigue, headaches are expected, but without waiting for the disease to progress to severe forms affecting the heart, at the same time, these symptoms may suddenly appear. In case of excess, cardiac investigations are recommended. Especially if the fever persists for more than 3 days, the course of the disease may be more severe with the involvement of the heart vessels in the disease. In this case, it is necessary to be examined for Covid-related heart disease if the fever persists and there is no other reason.
How should the follow-up be?
During the course of the disease, clinical follow-up is required in terms of cardiovascular disease. Inflammation of the heart muscle, inflammation of the heart valves, inflammation of the heart membrane, deterioration of the heart pump function, development of rhythm disorders and sudden deterioration of the general condition, which are frequently detected during the course of Covid-19 disease in children, besides conducting cardiological examinations, it is closely related to cardiovascular disease during the course of the disease. Continued follow-up is required.