Heart failure reported in 2-month-old with COVID-19: JACC: Case Reports
Yet another cardiac complication to watch out for- Reversible heart failure was reported in a 2-month-old with COVID-19.
A 2-month-old infant diagnosed with COVID-19 experienced reversible myocardial injury and heart failure, similar to COVID-19 related heart issues seen in adults. The infant recovered with normal heart function and was discharged with no heart failure medications.
The case has been published in JACC: Case Reports.
Since the earliest reports of COVID-19 in China, there have been indications of myocardial injury in some patients. In early cohorts of adult patients hospitalized with COVID -19, studies showed as many as between 20-28% of patients showing evidence of myocardial injury. Most of the patients with myocardial injury had pre-existing cardiovascular disease.
In this case, a 2-month-old infant presented with choking and bluish discoloration of the skin after feeding. The child had no history of fever, cough, upper respiratory tract infection symptoms, diarrhea, vomiting or decreased feeding prior to the first presentation. The patient was born pre-maturely at 33 weeks and stayed in the NICU for three weeks, including one week of nasal continuous positive airway pressure.
The patient's initial COVID-19 test was negative, but a repeat test was positive. An ECG showed myocardial injury due to the viral infection and heart failure symptoms exacerbated by the viral infection. Tests ruled out all other possible viral causes for the myocardial injury. The patient required fluid resuscitation and inotropic support for hypotension, as well as mechanical ventilation for respiratory failure. The patient also received remdesivir under a compassionate use order.
"The presentation and clinical course of this patient mirrors four case reports of acute myocardial injury reported in adult patients with COVID-19," said Madhu Sharma, MD, lead author of the case report and a pediatric cardiologist at The Children's Hospital at Montefiore. "Most children with COVID-19 are either asymptomatic or have mild symptoms, but our case shows the potential for reversible myocardial injury in infants with COVID-19. Testing for COVID-19 in children presenting with signs and symptoms of heart failure is very important as we learn more about the impact of this virus."
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Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as an Editor-in-Chief for the Speciality Medical Dialogues section. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Before Joining Medical Dialogues, he has served at important positions in the medical industry in India including as the Hony. Secretary of the Delhi Medical Association as well as the chairman of Anti-Quackery Committee in Delhi and worked with other Medical Councils in India. Email: email@example.com. Contact no. 011-43720751