Nepal Medical College and Teaching Hospital, Kathmandu, Nepal.
Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, Nepal.
BMC Cardiovasc Disord. 2024 Nov 28;24(1):686. doi: 10.1186/s12872-024-04366-0.
Respiratory viruses are linked to cardiovascular complications. We aim to compare cardiovascular complications due to COVID-19, influenza and RSV.
We analyzed cross-sectional data from hospitalized children and young adults (≤ 20 years) from 2020 and 2021 using National Inpatient Sample (NIS). We included individuals hospitalized for COVID-19, RSV, and influenza, and weighted data were used to compare cardiovascular complications.
Of 212,655 respiratory virus admissions, 85,055 were from COVID-19, 103,185 were from RSV, and 24,415 were from influenza. Myocarditis was higher in COVID-19 [0.9%, n = 740] as compared to influenza [0.2%, n = 55] and RSV [0.1%, n = 65]. In the adjusted logistic regression, the odds of myocarditis was 61% lower in influenza [aOR = 0.39 (0.20-0.76), P = 0.006], and 85% lower in RSV [aOR = 0.15 (0.07-0.34) P < 0.001] as compared to COVID-19. Bradyarrhythmias/heart block was higher in COVID-19 [0.8%, n = 690] versus influenza [0.5%, n = 110] and RSV [0.2%, n = 205]. After adjusting for confounders for bradyarrhythmias/heart block, compared to COVID-19, the odds were 49% lower in RSV [aOR = 0.51 (0.33-0.80), P = 0.004] but no statistically significant difference in influenza [aOR = 0.79 (0.48-1.31), P = 0.374] was seen. Tachyarrhythmias, sudden cardiac arrest, and in-hospital mortality showed no differences after adjusting for covariates.
Individuals with COVID-19 infection are more likely to develop cardiovascular complications compared to influenza and RSV, highlighting the need for higher index of suspicion and prompt treatment, as well as steps to limit infection and transmission of this virus in children.
呼吸道病毒与心血管并发症有关。我们旨在比较 COVID-19、流感和 RSV 引起的心血管并发症。
我们使用国家住院患者样本（NIS）分析了 2020 年和 2021 年住院的儿童和青年（≤20 岁）的横断面数据。我们纳入了因 COVID-19、RSV 和流感住院的个体，并使用加权数据比较了心血管并发症。
在 212655 例呼吸道病毒入院患者中，85055 例来自 COVID-19，103185 例来自 RSV，24415 例来自流感。与流感（0.2%，n=55）和 RSV（0.1%，n=65）相比，COVID-19 患者的心肌炎发生率更高[0.9%，n=740]。在调整后的逻辑回归中，流感的心肌炎发生率降低 61%[调整后比值比（aOR）=0.39（0.20-0.76），P=0.006]，RSV 降低 85%[aOR=0.15（0.07-0.34），P<0.001]。与 COVID-19 相比，COVID-19 患者的心动过缓/心脏阻滞发生率更高[0.8%，n=690]，而流感患者为[0.5%，n=110]，RSV 患者为[0.2%，n=205]。在调整心动过缓/心脏阻滞的混杂因素后，与 COVID-19 相比，RSV 的比值比降低 49%[aOR=0.51（0.33-0.80），P=0.004]，而流感无统计学差异[aOR=0.79（0.48-1.31），P=0.374]。调整协变量后，未发现心律失常、心源性骤停和住院死亡率的差异。
与流感和 RSV 相比，COVID-19 感染患者更有可能发生心血管并发症，这凸显了需要更高的怀疑指数和及时治疗，以及采取措施限制该病毒在儿童中的感染和传播。
