Niaz Talha, Hope Kyle, Fremed Michael, Misra Nilanjana, Altman Carrie, Glickstein Julie, Sanchez-de-Toledo Joan, Fraisse Alain, Miller Jacob, Snyder Christopher, Johnson Jonathan N, Chowdhury Devyani
Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.
Division of Pediatric Cardiology, Department of Pediatrics, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.
Pediatr Cardiol. 2021 Jan;42(1):19-35. doi: 10.1007/s00246-020-02476-y. Epub 2020 Oct 4.
Coronavirus disease 2019 (COVID-19) has affected patients across all age groups, with a wide range of illness severity from asymptomatic carriers to severe multi-organ dysfunction and death. Although early reports have shown that younger age groups experience less severe disease than older adults, our understanding of this phenomenon is in continuous evolution. Recently, a severe multisystem inflammatory syndrome in children (MIS-C), with active or recent COVID-19 infection, has been increasingly reported. Children with MIS-C may demonstrate signs and symptoms of Kawasaki disease, but also have some distinct differences. These children have more frequent and severe gastrointestinal symptoms and are more likely to present with a shock-like presentation. Moreover, they often present with cardiovascular involvement including myocardial dysfunction, valvulitis, and coronary artery dilation or aneurysms. Here, we present a review of the literature and summary of our current understanding of cardiovascular involvement in children with COVID-19 or MIS-C and identifying the role of a pediatric cardiologist in caring for these patients.
2019年冠状病毒病（COVID-19）已影响到所有年龄组的患者，疾病严重程度范围广泛，从无症状携带者到严重的多器官功能障碍及死亡。尽管早期报告显示，较年轻年龄组的疾病严重程度低于老年人，但我们对这一现象的理解仍在不断演变。最近，越来越多关于患有活动性或近期COVID-19感染的儿童出现严重多系统炎症综合征（MIS-C）的报告。患有MIS-C的儿童可能表现出川崎病的体征和症状，但也存在一些明显差异。这些儿童出现胃肠道症状的频率更高、症状更严重，且更易出现类似休克的表现。此外，他们常伴有心血管受累，包括心肌功能障碍、瓣膜炎以及冠状动脉扩张或动脉瘤。在此，我们对文献进行综述，并总结目前对COVID-19或MIS-C患儿心血管受累情况的理解，以及确定儿科心脏病专家在照料这些患者中的作用。
