Alammouri Iyad, Odeh Aya E, Alkhaled Farah A, Al-Zoubi Razan M, Alzagareet Yaqin M
Pediatrics, School of Medicine, The University of Jordan, Amman, JOR.
Cureus. 2024 Oct 14;16(10):e71407. doi: 10.7759/cureus.71407. eCollection 2024 Oct.
Chest pain is a common complaint among pediatric patients, often leading to visits to Emergency Departments or outpatient clinics. While most cases are benign, timely diagnosis is essential to prevent fatalities in those with serious conditions. The COVID-19 pandemic has shifted healthcare dynamics, necessitating an understanding of its impact on pediatric health, including potential complications such as chest pain, fever, cough, shortness of breath, sore throat, and headache. This study aims to explore the prevalence, characteristics, and potential association between COVID-19 and chest pain in children during two time periods: 2019 (before the COVID-19 pandemic) and 2021 (the full year during the pandemic).
Data were collected from medical records and telephone interviews with pediatric patients presenting with chest pain at the University of Jordan Hospital. The study included a sample size of 3294 patients with selection criteria based on presenting symptoms and COVID-19 status. Data collection occurred from 2019 and 2021, and demographic information (age, gender, weight), medical history (perinatal and family history), COVID-19 status (vaccination, infection history), and details about chest pain (frequency, onset) were documented. Statistical analyses were performed to evaluate differences between the two time periods using IBM SPSS Statistics for Windows, Version 28 (Released 2021; IBM Corp., Armonk, New York, United States).
The results indicate a significant increase in the number of patients presenting with chest pain in 2021 compared to 2019 (P value = .0157). The mean age of patients was 11 years, predominantly male. There was a notable increase in the percentage of patients with comorbidities in 2021. Echocardiography results were normal in approximately 84% of cases across both years, with no significant differences in ECG outcomes. Palpitations remained the most common associated symptom. 4.6 % of patients in 2021 were confirmed to have COVID-19, most of whom were diagnosed with muscular causes of chest pain. Notably, none of the patients had received the COVID-19 vaccine.
This study highlights a marked increase in pediatric patients presenting with chest pain during the pandemic, although characteristics and underlying causes remained consistent between years. The rise in cases may be attributed to heightened awareness rather than a direct link to COVID-19. Recommendations for clinical practice include careful evaluation of chest pain in pediatric patients during the pandemic, considering psychosocial factors and the broader impact of COVID-19 on health-seeking behaviors. Future research should investigate the long-term effects of COVID-19 on pediatric populations and explore the psychological implications on health service utilization. This study underscores the need for ongoing assessment of pediatric healthcare practices amid evolving pandemic conditions.
胸痛是儿科患者的常见主诉，常导致他们前往急诊科或门诊就诊。虽然大多数病例是良性的，但及时诊断对于预防严重疾病患者的死亡至关重要。新冠疫情改变了医疗格局，有必要了解其对儿童健康的影响，包括胸痛、发热、咳嗽、呼吸急促、喉咙痛和头痛等潜在并发症。本研究旨在探讨2019年（新冠疫情之前）和2021年（疫情全年）这两个时间段内新冠与儿童胸痛之间的患病率、特征及潜在关联。
数据收集自约旦大学医院出现胸痛症状的儿科患者的病历和电话访谈。该研究纳入了3294例患者的样本量，入选标准基于呈现的症状和新冠状态。数据收集时间为2019年和2021年，记录了人口统计学信息（年龄、性别、体重）、病史（围产期和家族史）、新冠状态（疫苗接种、感染史）以及胸痛的详细信息（频率、发作情况）。使用IBM SPSS Statistics for Windows 28版（2021年发布；IBM公司，美国纽约州阿蒙克）进行统计分析，以评估两个时间段之间的差异。
结果表明，与2019年相比，2021年出现胸痛症状的患者数量显著增加（P值 = 0.0157）。患者的平均年龄为11岁，以男性为主。2021年合并症患者的百分比显著增加。两年中约84%的病例超声心动图结果正常，心电图结果无显著差异。心悸仍然是最常见的相关症状。2021年4.6%的患者确诊感染新冠，其中大多数被诊断为胸痛的肌肉原因。值得注意的是，没有患者接种过新冠疫苗。
本研究强调，疫情期间出现胸痛症状的儿科患者显著增加，尽管各年份之间的特征和潜在病因保持一致。病例增加可能归因于意识提高，而非与新冠有直接关联。临床实践建议包括在疫情期间仔细评估儿科患者的胸痛情况，考虑社会心理因素以及新冠对就医行为的更广泛影响。未来研究应调查新冠对儿童群体的长期影响，并探索其对医疗服务利用的心理影响。本研究强调在不断变化的疫情形势下持续评估儿科医疗实践的必要性。
