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Cardiology in the Young ; 32(Supplement 2):S248, 2022.
Article in English | EMBASE | ID: covidwho-2062092


Background and Aim: Coronavirus infection (COVID-19) in paedi-atric population has a generally mild course. In Spain, patients under 15 years old have accounted only for 0,4% of hospital admis-sions and 0,7% of intensive care admissions. However, in May 2020, cases of children with a systemic inflammatory syndrome related to a recent COVID-19 infection were described. In severe forms, left ventricular systolic dysfunction, mitral regurgitation, pericardial effusion and coronary artery dilatation or aneurysms have been described. The aim of this study is to describe the results obtained in cardiopulmonary exercise test (CPET) in previously healthy patients with PIMS. Method(s): Prospective study of PIMS patients who performed CPET. Godfrey ramp protocol recommended by European Society of Cardiology (ESC) was used in all cases. Measured var-iables, expressed by predicted values, were: forced vital capacity (FVC), forced expiratory volume (FEV1), ratio of minute venti-lation to carbon dioxide production (VE/VO2 slope), maximal oxygen consumption (VO2 max), oxygen uptake efficiency slope (OUES), oxygen pulse (O2 pulse) and maximum heart rate (HR). Result(s): Eight patients (75% boys) aged 5-14 years (median 10,5 years) performed CPET reaching a mean peak load of 105,87 W (median 112,5 W and mean load per kg of weight 2,34 W/kg). Only 1 patient (12,5%) presented basal spirometric disturb-ances in context of asthma without chronic treatment. Obtained mean respiratory parameters were: FVC 97,88%, FEV1 92,7%, Tiffeneau 83% and VECO2p 32,47. Oxygen satu-ration before and after CPET was greater than 95% in 100% of patients. In 6 patients (75%) the V02max and oxygen pulse was greater than 80% of predicted value (100% of patients reached at least 40% of V02 max at anaerobic threshold). Obtained mean cardiovascular parameters were: VO2 max 1624mL/min (median 1655 ml/min and V02 per kg of weight 36,9 ml/kg), pulse oxygen 9 ml and OUES 1,92. Conclusion(s): PIMS may cause severe cardiac disturbances justifying cardiological monitoring of these patients. CPET allows to assess functional capacity of these children after the disease. In our serie, most of patients had a good functional capacity (75%). Studies with more patients are needed to make extended conclusions.

Cardiology in the Young ; 32(Supplement 2):S241, 2022.
Article in English | EMBASE | ID: covidwho-2062091


Background and Aim: In April 2020, clinicians in the United Kingdom observed a group of children with hyperinflammatory shock with significant cardiovascular effects, with features similar to Kawasaki disease and toxic shock syndrome. This new syn-drome that is temporally related to previous exposure to SARS-CoV-2 infection, is now known as multisystem inflammatory syn-drome in children (MIS-C). The aim of this study is to describe the incidence, the clinical, laboratory and echocardiografic character-istics of hospitalized children who met criteria for the MIS-C and analyse short time general and cardiac outcomes in our region. Method(s): Data from children admitted who fulfilled the case def-inition of MIS-C were collected between October 2020 and November 2021. Result(s): 10 cases of MIS-C were reported;the incidence of MIS-C during this period was 1 per 10000 positive sars-cov2 cases (diag-nosed by polymerase chain reaction test or antigen test). The median age was 10 years (IQR 6-12). 70% were male and 50% corresponded to ethnic minority group in our country (20% Latin American and 30% African). 8 of 10 patients (80%) had evi-dence of current or prior SARS-CoV-2 infection and 2 of 10 (20%) had an antecedent of contact with a COVID positive patient. Fever (100% patients), hematologic disturbances (90%), cardiac involvement (biochemical or echocardiographic) (80%), gastrointestinal (80%) and mucocutaneus (50%) symptoms were common presenting features. 8 of 10 were admitted in the pedi-atric intensive care unit. When referring to cardiovascular involve-ment, 1 of 10 (10%) patients had left ventricular systolic dysfunction, 2 of 10 (20%) had mild pericardial effusion and 4 of 10 (40%) mild coronary artery abnormalities. Conclusion(s): Although the incidence is low, in this case series most patients show homogeneous clinical and laboratory findings. Since cardiac involvement is described in a high proportion of patients, long-term follow-up is required due to the unclear prognosis and risk of progression of cardiac manifestation.

Cardiology in the Young ; 32(Supplement 2):S242, 2022.
Article in English | EMBASE | ID: covidwho-2062090


Background and Aim: Since December 2019 the novel coronavirus disease 2019 (COVID-19) has been burdening all health systems worldwide. However, cardiopulmonary repercussions in paediat-ric patients with congenital heart disease (CHD) are unknown. The aim of this study is to compare changes in cardiopulmonary exercise test (CPET) in this patients before and after COVID-19. Method(s): Prospective observational study was lead comparing CPET results after COVID-19 in paediatric patients with stable CHD who had a previous routine CPET. All underwent for stand-ardised CPET, using Godfrey ramp protocol as recommended by the European Society of Cardiology (ESC). Measured variables, expressed by predicted values, were: forced vital capacity (FVC), forced expiratory volume (FEV1), ratio of minute venti-lation to carbon dioxide production (VE/VO2 slope), peak oxy-gen consumption (peak VO2), oxygen uptake efficiency slope (OUES), oxygen pulse (O2 pulse) and peak heart rate (pHR). Wilcoxon test was used to compare continuous variables for related samples. Result(s): Ten patients (6 boys, 60%;mean age 11,4 +/- 2,4 years) with hemodynamically stable CHD (3 Tetralogy of Fallot, 30%;2 trans-position of the great arteries, 20%;2 dilated cardiomyopathy, 20%;2 Kawasaki disease, 20%;1 cardiac tumor, 10%) were selected to repeat a post-COVID CPET. All of them had mild COVID and could follow ambulatory treatment. Comparing before/post COVID tests, there were no significantly changes in predicted res-piratory parameters: FVC (90,6 +/- 7,4 vs 98,1 +/- 23,9%;p = 0,799), FEV1 (89,5 +/- 13,8 vs 94,5 +/- 8,8%;p = 0,475), VE/CO2 slope (31,6 +/- 3,7 vs 30,6 +/- 3,9degree, p = 0,203). In the same way, no significantly changes were seen in cardiovascular predicted parameters: oxygen pulse (97,3 +/- 19,2 vs 98,5 +/- 17,4%, p = 0,798), peak VO2 (82,4 +/- 19,4 vs 76,8 +/- 13,7;p = 0,123) and OUES (1,79 +/- 0,4 vs 2,01 +/- 0,6;p = 0,066). Respect peak VO2, there was a non-significant slightly decrease in post-COVID test (82,4 +/- 19,4 vs 76,8 +/- 13,7;p = 0,123). Conclusion(s): In our series, post-COVID CPET results showed that paediatric patients with hemodynamically stable CHD had no impairment in their functional capacity in relation to Sars-CoV-2 disease. Contrary to adults with previous cardiovascular disease, children should have mild infections without sequelae in cardio-pulmonary function.