ABSTRACT
Background and Aim: Clinical manifestations of children's corona-virus disease-2019 (COVID-19) are generally considered less severe compared with adult patients. The objective of this study was to evaluate cardiac involvement in healthy children with asymptomatic or mildly symptomatic severe acute respiratory syn-drome coronavirus-2 (SARS-CoV-2) infection. Method(s): We analysed a cohort of 210 paediatric patients, mean age 7 +/- 4 years, who had a confirmed diagnosis of SARS-CoV-2 infection and were asymptomatic or mildly symptomatic for COVID-19. Patients underwent standard transthoracic echocardiogram and speckle tracking echocardiographic study 138 +/- 65 days after diagnosis. Seventy-two age, sex, and body sur-face area comparable healthy subjects were used as control group. Result(s): Left ventricular ejection fraction was within normal limits but significantly lower in the cases group compared to controls (62 +/- 4% vs. 65 +/- 5%;P = 0.012). Left ventricular (LV) global longi-tudinal strain (-20,91 +/- 2,83 % vs.-22,73 +/- 2,51 %;P lt;0.001) was significantly reduced in cases compared with CTRLs. Regional LV strain analysis showed a significant reduction of the LV mid-wall segments strain among cases compared to controls. Furthermore, in the cases group, there were 25% of subjects with a regional peak systolic strain below-16% (-2.5 Z score in our healthy cohort) in at least two segments. These subjects did not show any difference regarding symptoms or serological findings. Conclusion(s): SARS-CoV-2 infection may affect left ventricular deformation in 26% of children despite an asymptomatic or only mildly symptomatic acute illness. A follow-up is needed to verify the reversibility of these alterations and their impact on long-term outcomes.