Echocardiography and laboratory outcomes of COVID-19 in children with a history of Kawasaki disease: a preliminary observation

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Yu-Jhen Chen¹  Ling-Sai Chang¹  Ho-Chang Kuo²  Mindy Ming-Huey Guo³ 

[1] Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan;Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan;College of Medicine, Chang Gung University, Taoyuan, Taiwan;Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan;Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan;College of Medicine, Chang Gung University, Taoyuan, Taiwan;Department of Respiratory Therapy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan;Kawasaki Disease Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan;Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan;College of Medicine, Chang Gung University, Taoyuan, Taiwan;School of Medicine, Chung Shan Medical University, Taichung, Taiwan;

关键词: Kawasaki disease;    COVID-19;    echocardiography;    vaccine;    coronary artery lesions;   

DOI  :  10.3389/fcvm.2023.1127892

 received in 2022-12-22, accepted in 2023-09-18,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundInfection with SARS-CoV-2 virus has been associated with cardiovascular sequelae including multisystem inflammatory syndrome (MIS-C) in children. Patients with a prior history of Kawasaki disease, may be more susceptible to changes in echocardiographic or laboratory findings after COVID-19. The objective of this study was to investigate the echocardiographic and laboratory findings in children with a prior history of Kawasaki disease after SARS-CoV-2 infection.Materials and methodsIn this study, we performed a retrospective chart review of 41 children younger than 18 years old who were diagnosed with COVID-19 from April to August of 2022 and had a prior history KD. We included echocardiography and blood draw data obtained at the last outpatient follow-up at our hospital for KD, and within 4 months of SARS-CoV-2 infection. Echocardiographic data obtained from 82 age-matched and gender matched controls were also included for comparison.ResultsWe found that COVID-19 resulted in slightly higher RCA Z-scores within the first month after infection (mean ± SE, 1.20 ± 0.18 vs. 0.83 ± 0.18, p = 0.030), although this increase did not result in coronary artery dilatation, defined as a Z-score of at least 2.5. In addition, we found that degree of RCA dilatation after COVID-19 infection was negatively correlated with the change in monocyte percentage (Pearson's correlation coefficient—0.363, p = 0.020). Moreover, RCA Z-score changes were lower in patients who received at least one dose of mRNA COVID-19 vaccine when compared those who did not receive any (mean ± SE, −0.23 ± 0.16 vs. 0.39 ± 0.17, p = 0.031).ConclusionIn this pilot study we found that COVID-19 infection resulted in slightly higher RCA Z-scores in children with a prior history of KD, although not large enough to be classified as coronary aneurysms. While these changes could be the result of measurement imprecision or interobserver variation, further study of the cardiac outcomes of COVID-19 infection in children with a prior history of KD are needed in the future.

【 授权许可】

Unknown   
© 2023 Guo, Chang, Chen and Kuo.