TY - JOUR
T1 - Cardiovascular sequelae from COVID-19
T2 - Perspectives from a paediatric cardiac ICU
AU - Lasa, Javier J.
AU - Alali, Alexander
AU - Anders, Marc
AU - Tume, Sebastian C.
AU - Muscal, Eyal
AU - Tejtel, S. Kristen Sexson
AU - Shekerdemian, Lara
N1 - Publisher Copyright:
© The Author(s), 2022. Published by Cambridge University Press.
PY - 2023/1/24
Y1 - 2023/1/24
N2 - Objective: Paediatric ICUs have shared the burden of the COVID-19 pandemic, including subspecialty cardiac ICUs. We sought to address knowledge gaps regarding patient characteristics, acuity, and sequelae of COVID-19 in the paediatric cardiac ICU setting. Design: Retrospective review of paediatric cardiac ICU admissions with COVID-19-related disease. Setting: Single centre tertiary care paediatric cardiac ICU. Patients: All patients with PCR/antibody evidence of primary COVID-19 infection, and/or Multisystem Inflammatory Syndrome in Children, were admitted between 26 March, 2020 and 31 March, 2021. Interventions: None. Main outcomes measures: Patient-level demographics, pre-existing conditions, clinical symptoms, and outcomes related to ICU admission were captured from medical records. Results: Among 1064 patients hospitalised with COVID-19/Multisystem Inflammatory Syndrome in Children, 102 patients (9.5%) were admitted to cardiac ICU, 76 of which were symptomatic (median age 12.5 years [IQR 7.5-16.0]). The primary system involved at presentation was cardiovascular in 48 (63%). Vasoactive infusions were required in 62% (n = 47), with eight patients (11%) requiring VA ECMO. Severity of disease was categorised as mild/moderate in 16 (21%) and severe/critical in 60 patients (79%). On univariate analysis, African-American race, presentation with gastrointestinal symptoms or elevated inflammatory markers were associated with risk for severe disease. All-cause death was observed in five patients (7%, n = 5/72) with four patients remaining hospitalised at the time of data query. Conclusion: COVID-19 and its cardiovascular sequelae were associated with important morbidity and significant mortality in a notable minority of paediatric patients admitted to a paediatric cardiac ICU. Further study is required to quantify the risk of morbidity and mortality for COVID-19 and sequelae.
AB - Objective: Paediatric ICUs have shared the burden of the COVID-19 pandemic, including subspecialty cardiac ICUs. We sought to address knowledge gaps regarding patient characteristics, acuity, and sequelae of COVID-19 in the paediatric cardiac ICU setting. Design: Retrospective review of paediatric cardiac ICU admissions with COVID-19-related disease. Setting: Single centre tertiary care paediatric cardiac ICU. Patients: All patients with PCR/antibody evidence of primary COVID-19 infection, and/or Multisystem Inflammatory Syndrome in Children, were admitted between 26 March, 2020 and 31 March, 2021. Interventions: None. Main outcomes measures: Patient-level demographics, pre-existing conditions, clinical symptoms, and outcomes related to ICU admission were captured from medical records. Results: Among 1064 patients hospitalised with COVID-19/Multisystem Inflammatory Syndrome in Children, 102 patients (9.5%) were admitted to cardiac ICU, 76 of which were symptomatic (median age 12.5 years [IQR 7.5-16.0]). The primary system involved at presentation was cardiovascular in 48 (63%). Vasoactive infusions were required in 62% (n = 47), with eight patients (11%) requiring VA ECMO. Severity of disease was categorised as mild/moderate in 16 (21%) and severe/critical in 60 patients (79%). On univariate analysis, African-American race, presentation with gastrointestinal symptoms or elevated inflammatory markers were associated with risk for severe disease. All-cause death was observed in five patients (7%, n = 5/72) with four patients remaining hospitalised at the time of data query. Conclusion: COVID-19 and its cardiovascular sequelae were associated with important morbidity and significant mortality in a notable minority of paediatric patients admitted to a paediatric cardiac ICU. Further study is required to quantify the risk of morbidity and mortality for COVID-19 and sequelae.
KW - COVID-19
KW - MIS-C
KW - cardiac ICU
KW - intensive care
KW - paediatric
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U2 - 10.1017/S1047951122000130
DO - 10.1017/S1047951122000130
M3 - Article
C2 - 35197133
AN - SCOPUS:85126037407
SN - 1047-9511
VL - 33
SP - 52
EP - 59
JO - Cardiology in the Young
JF - Cardiology in the Young
IS - 1
ER -