COVID-19 and Cardiac Implications—Still a Mystery in Clinical Practice
Reka Borka Balas, Lorena Elena Meliț, Cristina Oana Mărginean
Reviews in Cardiovascular Medicine, doi:10.31083/j.rcm2405125
Although initially the evolution of Coronavirus disease 2019 (COVID-19) seemed less severe in pediatric patients, in the three years since the beginning of the pandemics, several severe cases have been described, pediatric inflammatory multisystem syndrome (PIMS) has been defined, pathogenesis is being continuously studied, and many aspects regarding the long-term evolution and multi-organ damage are still unexplained. Cardiac injuries in COVID-19 represent most-likely the second cause of mortality associated with the infection. A widespectrum of cardiac abnormalities were reported to be associated with COVID-19 in children including ventricular dysfunction, acute myocardial dysfunction, arrhythmias, conduction abnormalities, coronary artery dilation or aneurysms, and less common pericarditis and valvulitis. Risk factors for severe COVID-19 in children should be identified, laboratory tests and imaging techniques should be performed to reveal cardiac injury as soon as possible. The aim of this review was to highlight the great value of repeated cardiological monitoring in patients with COVID-19, underlining also the peculiarities in terms of pediatric population. This review is looking for answers on questions like 'Why do some, but not all, patients with COVID-19 develop cardiac injury or severe hyperinflammatory status?', 'Which factors are involved in triggering COVID-19 associated cardiac injury?', 'What are the mechanisms involved in the etiology of cardiac injury?', 'Is there a clear relationship between hyperinflammation and cardiac injury?', 'Is hyperinflammatory status the pre-stage of cardiac injury in COVID-19 patients?' which still lack clear answers. The understanding of mechanisms involved in the development of COVID-19 associated cardiac injury might shed light on all the above-mentioned mysteries and might increase the likelihood of favorable evolution even in severe cases.
Author Contributions RBB, LEM and COM designed the review. RBB, LEM performed the research of the literature. COM provided help and advice LEM and RBB on design and research of the literature. RBB, LEM and COM wrote the manuscript. All authors contributed to editorial changes in the manuscript. All authors read and approved the final manuscript.
Ethics Approval and Consent to Participate Not applicable.
Conflict of Interest The authors declare no conflict of interest.
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