Role of a Pediatric Cardiologist in the COVID-19 Pandemic
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REVIEW ARTICLE
Role of a Pediatric Cardiologist in the COVID‑19 Pandemic Talha Niaz1 · Kyle Hope2 · Michael Fremed3 · Nilanjana Misra4 · Carrie Altman2 · Julie Glickstein3 · Joan Sanchez‑de‑Toledo5 · Alain Fraisse6 · Jacob Miller7 · Christopher Snyder8 · Jonathan N. Johnson1 · Devyani Chowdhury9 Received: 19 August 2020 / Accepted: 26 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Coronavirus disease 2019 (COVID-19) has affected patients across all age groups, with a wide range of illness severity from asymptomatic carriers to severe multi-organ dysfunction and death. Although early reports have shown that younger age groups experience less severe disease than older adults, our understanding of this phenomenon is in continuous evolution. Recently, a severe multisystem inflammatory syndrome in children (MIS-C), with active or recent COVID-19 infection, has been increasingly reported. Children with MIS-C may demonstrate signs and symptoms of Kawasaki disease, but also have some distinct differences. These children have more frequent and severe gastrointestinal symptoms and are more likely to present with a shock-like presentation. Moreover, they often present with cardiovascular involvement including myocardial dysfunction, valvulitis, and coronary artery dilation or aneurysms. Here, we present a review of the literature and summary of our current understanding of cardiovascular involvement in children with COVID-19 or MIS-C and identifying the role of a pediatric cardiologist in caring for these patients. Keywords COVID-19 · Pediatric · Cardiovascular · MIS-C Abbreviations AAP American Academy of Pediatrics ACC American College of Cardiology AHA American Heart Association ASE American Society of Echocardiography BNP Brain natriuretic peptide CDC Center for Disease Control and Prevention CHIP Child’s Health Insurance Program CK Creatine kinase CMR Cardiac magnetic resonance
CMS Centers for Medicare and Medicaid Services COVID-19 Coronavirus disease 2019 CRP C-reactive protein CTA Computed tomographic angiography ECG Electrocardiogram ECMO Extracorporeal membrane oxygenation EHB Essential Health Benefit ESR Erythrocyte sedimentation rate GI Gastrointestinal
* Devyani Chowdhury [email protected]
5
Department of Cardiology, Hospital Sant Joan de Deu, Barcelona, Spain
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Paediatric Cardiology Services, Royal Brompton and Harefield Hospitals Trust, National Heart and Lung Institute, Imperial College, London, UK
7
Section of Pediatric Cardiothoracic Surgery, Washington University School of Medicine, St Louis Children’s Hospital, St Louis, MO, USA
8
Pediatric Cardiology, Rainbow Babies and Children’s Hospital, Case Western Reserve University, School of Medicine, Cleveland, OH, USA
9
Cardiology Care for Children, 1834 Oregon Pike, Ste 20, Lancaster, PA 17601, USA
1
Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
2
Division of Pediatric Car
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