High prevalence of cardiovascular complications in children with COVID-19: A cohort study from Assiut University children’s Hospital

Background: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of COVID-19, has increasingly been recognized not only for its respiratory manifestations but also for its significant cardiovascular complications. These complications include myocarditis, various arrhythmias, myocardial inflammation, and coagulation abnormalities, all of which may contribute to morbidity in pediatric patients. This study aimed to assess the prevalence and patterns of cardiovascular involvement among children diagnosed with COVID-19 who were admitted to the pediatric pulmonary and cardiology units at Assiut University Children’s Hospital. Methods: A total of 66 pediatric patients with COVID-19 were enrolled in this long-term observational study. According to the World Health Organization (WHO) severity criteria, detailed clinical evaluations and laboratory parameters were recorded, with a special focus on cardiac biomarkers. Results: Cardiovascular complications were detected in a considerable proportion of patients. Myocarditis was the most prevalent complication, affecting 30.3% of cases, followed by tachycardia in 25.76%. Acute heart failure occurred in 9.9%, atrioventricular block in 13.64%, and deep venous thrombosis in 6.06% of patients. Less frequent complications included cardiac arrest (4.55%), mitral regurgitation (4.55%), pericarditis with ST elevation (3.03%), and atrial thrombosis (1.53%). Elevated troponin and CK-MB levels showed significant positive correlations with tachycardia, tachypnea, and left ventricular dilatation (P < 0.05). Conclusion: Cardiovascular complications are common among pediatric patients with COVID-19, with myocarditis being the most frequent manifestation. These findings underscore the importance of early cardiac evaluation and structured six-month follow-up to enable timely detection and management of cardiac involvement and potentially reduce morbidity.