Serious cardiac events in the COVID-19 era in the paediatric population: what did we learn?

BACKGROUND: Serious cardiac events, which are frequently associated with myocarditis or arrhythmias, pose serious public health concerns. COVID-19 can increase cardiovascular risks by causing cardiac damage, arrhythmias, and multisystem inflammatory syndrome in children. However, important knowledge gaps about the long-term cardiac effects of COVID-19 still exist. These lead to the possibility of unusual or delayed cardiac consequences and the requirement for specialised monitoring techniques to reduce potential risks, particularly in high-risk populations. This narrative review compares serious cardiac event incidence, mechanisms, and outcomes in adults and children. METHODS: Data were gathered from peer-reviewed studies between 2019 and 2025, such as systematic reviews, clinical reports, and cohort analyses. Focus was placed on the potential contribution of COVID-19-related cardiac events. Key research and clinical practice gaps were identified by analysing paediatric and adult populations in terms of diagnostic methods, management techniques, and long-term results. RESULTS: While vaccine-related cardiac complications are still uncommon, COVID-19 infection is linked to an increased risk of serious cardiac events in adults. Paediatric serious cardiac events, on the other hand, are rare but frequently associated with multisystem inflammatory syndrome in children, and there have been rare, documented vaccine-associated deaths in this population. CONCLUSION: Significant findings reveal clear patterns in serious cardiac events mechanisms, with age-dependent differences in the severity and prognosis of COVID-19-related myocarditis, arrhythmias, and long QT syndrome, among others. These variations highlight the necessity of age-appropriate risk assessment and management techniques. In the context of COVID-19, these findings highlight distinct risk profiles for serious cardiac events, underscoring the need for targeted screening methods and focused public health initiatives.