Mid- and Long-Term Atrio-Ventricular Functional Changes in Children after Recovery from COVID-19
Background: Although most children may experience mild to moderate symptoms and do not require hospitalization, there are little data on cardiac involvement in COVID-19. However, cardiac involvement is accurately demonstrated in children with MISC. The objective of this study was to evaluate cardiac...
| Main Authors: | , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-12-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/12/1/186 |
| _version_ | 1797625505276493824 |
|---|---|
| author | Jolanda Sabatino Costanza Di Chiara Angela Di Candia Domenico Sirico Daniele Donà Jennifer Fumanelli Alessia Basso Pietro Pogacnik Elena Cuppini Letizia Rosa Romano Biagio Castaldi Elena Reffo Alessia Cerutti Roberta Biffanti Sandra Cozzani Carlo Giaquinto Giovanni Di Salvo |
| author_facet | Jolanda Sabatino Costanza Di Chiara Angela Di Candia Domenico Sirico Daniele Donà Jennifer Fumanelli Alessia Basso Pietro Pogacnik Elena Cuppini Letizia Rosa Romano Biagio Castaldi Elena Reffo Alessia Cerutti Roberta Biffanti Sandra Cozzani Carlo Giaquinto Giovanni Di Salvo |
| author_sort | Jolanda Sabatino |
| collection | DOAJ |
| description | Background: Although most children may experience mild to moderate symptoms and do not require hospitalization, there are little data on cardiac involvement in COVID-19. However, cardiac involvement is accurately demonstrated in children with MISC. The objective of this study was to evaluate cardiac mechanics in previously healthy children who recovered from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in a long-term follow-up by means of two-dimensional speckle-tracking echocardiography (STE). Methods: We analyzed a cohort of 157 paediatric patients, mean age 7.7 ± 4.5 years (age range 0.3–18 years), who had a laboratory-confirmed diagnosis of SARS-CoV-2 infection and were asymptomatic or mildly symptomatic for COVID-19. Patients underwent a standard transthoracic echocardiogram and STE at an average time of 148 ± 68 days after diagnosis and were divided in three follow-up groups (<180 days, 180–240 days, >240 days). Patients were compared with 107 (41 females—38%) age- and BSA-comparable healthy controls (CTRL). Results: Left ventricular (LV) global longitudinal strain (post-COVID-19: −20.5 ± 2.9%; CTRL: −21.8 ± 1.7%; <i>p</i> < 0.001) was significantly reduced in cases compared with CTRLs. No significant differences were seen among the three follow-up groups (<i>p</i> = NS). Moreover, regional longitudinal strain was significantly reduced in LV apical-wall segments of children with disease onset during the second wave of the COVID-19 pandemic compared to the first wave (second wave: −20.2 ± 2.6%; first wave: −21.2 ± 3.4%; <i>p</i> = 0.048). Finally, peak left atrial systolic strain was within the normal range in the post-COVID-19 group with no significant differences compared to CTRLs. Conclusions: Our study demonstrated for the first time the persistence of LV myocardial deformation abnormalities in previously healthy children with an asymptomatic or mildly symptomatic (WHO stages 0 or 1) COVID-19 course after an average follow-up of 148 ± 68 days. A more significant involvement was found in children affected during the second wave. These findings imply that subclinical LV dysfunction may also be a typical characteristic of COVID-19 infection in children and are concerning given the predictive value of LV longitudinal strain in the general population. |
| first_indexed | 2024-03-11T09:57:23Z |
| format | Article |
| id | doaj.art-dd3632ed12524182806569c796a7a3eb |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T09:57:23Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-dd3632ed12524182806569c796a7a3eb2023-11-16T15:42:36ZengMDPI AGJournal of Clinical Medicine2077-03832022-12-0112118610.3390/jcm12010186Mid- and Long-Term Atrio-Ventricular Functional Changes in Children after Recovery from COVID-19Jolanda Sabatino0Costanza Di Chiara1Angela Di Candia2Domenico Sirico3Daniele Donà4Jennifer Fumanelli5Alessia Basso6Pietro Pogacnik7Elena Cuppini8Letizia Rosa Romano9Biagio Castaldi10Elena Reffo11Alessia Cerutti12Roberta Biffanti13Sandra Cozzani14Carlo Giaquinto15Giovanni Di Salvo16Pediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyDepartment for Women’s and Children’s Health, Division of Pediatric Infectious Diseases, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyDepartment for Women’s and Children’s Health, Division of Pediatric Infectious Diseases, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyDepartment of Medical and Surgical Sciences, Division of Cardiology, Magna Graecia University of Catanzaro, Viale Europa 1, 88100 Catanzaro, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyDepartment for Women’s and Children’s Health, Division of Pediatric Infectious Diseases, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyDepartment for Women’s and Children’s Health, Division of Pediatric Infectious Diseases, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyPediatric and Congenital Cardiology Unit, Department for Women’s and Children’s Health, University Hospital of Padova, Via Nicolò Giustiniani 2, 35128 Padova, ItalyBackground: Although most children may experience mild to moderate symptoms and do not require hospitalization, there are little data on cardiac involvement in COVID-19. However, cardiac involvement is accurately demonstrated in children with MISC. The objective of this study was to evaluate cardiac mechanics in previously healthy children who recovered from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in a long-term follow-up by means of two-dimensional speckle-tracking echocardiography (STE). Methods: We analyzed a cohort of 157 paediatric patients, mean age 7.7 ± 4.5 years (age range 0.3–18 years), who had a laboratory-confirmed diagnosis of SARS-CoV-2 infection and were asymptomatic or mildly symptomatic for COVID-19. Patients underwent a standard transthoracic echocardiogram and STE at an average time of 148 ± 68 days after diagnosis and were divided in three follow-up groups (<180 days, 180–240 days, >240 days). Patients were compared with 107 (41 females—38%) age- and BSA-comparable healthy controls (CTRL). Results: Left ventricular (LV) global longitudinal strain (post-COVID-19: −20.5 ± 2.9%; CTRL: −21.8 ± 1.7%; <i>p</i> < 0.001) was significantly reduced in cases compared with CTRLs. No significant differences were seen among the three follow-up groups (<i>p</i> = NS). Moreover, regional longitudinal strain was significantly reduced in LV apical-wall segments of children with disease onset during the second wave of the COVID-19 pandemic compared to the first wave (second wave: −20.2 ± 2.6%; first wave: −21.2 ± 3.4%; <i>p</i> = 0.048). Finally, peak left atrial systolic strain was within the normal range in the post-COVID-19 group with no significant differences compared to CTRLs. Conclusions: Our study demonstrated for the first time the persistence of LV myocardial deformation abnormalities in previously healthy children with an asymptomatic or mildly symptomatic (WHO stages 0 or 1) COVID-19 course after an average follow-up of 148 ± 68 days. A more significant involvement was found in children affected during the second wave. These findings imply that subclinical LV dysfunction may also be a typical characteristic of COVID-19 infection in children and are concerning given the predictive value of LV longitudinal strain in the general population.https://www.mdpi.com/2077-0383/12/1/186long COVID-19childrenspeckle-tracking analysis |
| spellingShingle | Jolanda Sabatino Costanza Di Chiara Angela Di Candia Domenico Sirico Daniele Donà Jennifer Fumanelli Alessia Basso Pietro Pogacnik Elena Cuppini Letizia Rosa Romano Biagio Castaldi Elena Reffo Alessia Cerutti Roberta Biffanti Sandra Cozzani Carlo Giaquinto Giovanni Di Salvo Mid- and Long-Term Atrio-Ventricular Functional Changes in Children after Recovery from COVID-19 Journal of Clinical Medicine long COVID-19 children speckle-tracking analysis |
| title | Mid- and Long-Term Atrio-Ventricular Functional Changes in Children after Recovery from COVID-19 |
| title_full | Mid- and Long-Term Atrio-Ventricular Functional Changes in Children after Recovery from COVID-19 |
| title_fullStr | Mid- and Long-Term Atrio-Ventricular Functional Changes in Children after Recovery from COVID-19 |
| title_full_unstemmed | Mid- and Long-Term Atrio-Ventricular Functional Changes in Children after Recovery from COVID-19 |
| title_short | Mid- and Long-Term Atrio-Ventricular Functional Changes in Children after Recovery from COVID-19 |
| title_sort | mid and long term atrio ventricular functional changes in children after recovery from covid 19 |
| topic | long COVID-19 children speckle-tracking analysis |
| url | https://www.mdpi.com/2077-0383/12/1/186 |
| work_keys_str_mv | AT jolandasabatino midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT costanzadichiara midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT angeladicandia midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT domenicosirico midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT danieledona midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT jenniferfumanelli midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT alessiabasso midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT pietropogacnik midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT elenacuppini midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT letiziarosaromano midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT biagiocastaldi midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT elenareffo midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT alessiacerutti midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT robertabiffanti midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT sandracozzani midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT carlogiaquinto midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 AT giovannidisalvo midandlongtermatrioventricularfunctionalchangesinchildrenafterrecoveryfromcovid19 |