- Researchers report that heart complications in children after COVID-19 are rare and treatable.
- Some doctors also report that the number of cases for MIS-C and other conditions has decreased in recent months, perhaps due to the fact more children are eligible for COVID-19 vaccinations.
- Experts recommend parents watch children closely while they recover from COVID-19 and seek medical attention if there are any unusual or lingering symptoms.
As a novel virus, there is much we still don’t understand about COVID-19, even more than two years into a global pandemic.
However, for parents of children and young adults, there appears to be some positive news.
Heart complications arising from COVID-19 are rare and mostly treatable, according to a
“It is great that the AHA is highlighting the pediatric population with their scientific statement,” Dr. Simon Lee, a pediatric cardiologist at Nationwide Children’s Hospital in Columbus, Ohio, told Healthline. “We need continued emphasis on the need for research on the short- and long-term cardiovascular effects of COVID-19.”
For example, following COVID-19 infection, some children showed signs of a new multi-system inflammatory syndrome (MIS-C) that causes inflammation to vital organs, including the heart and lungs.
MIS-C is a serious concern but also relatively infrequent.
In the first year of the pandemic, the AHA researchers said that one of every 3,164 children with SARS-CoV-2 infection developed MIS-C. The overall risk of long-term complications and death from MIS-C was less than 2 percent.
Most children recovered from this disorder within one to four weeks of diagnosis.
That’s encouraging, but we shouldn’t consider the book closed on the issue entirely, said Dr. Allan Greissman, a pediatric intensivist at Pediatric Critical Care of South Florida.
“In the long-term, we’re going to have to study these children longitudinally with serial MRIs to look at their heart and the amount of scarring or fibrosis or even decreased function that can be seen on the cardiac MRI,” Greissman told Healthline.
He also said MIS-C cases appeared to be dropping.
“The amount of MIS-C we were seeing in relation to heart disease appeared to increase with the delta virus, but not so much with the omicron virus,” he explained. “The Omicron variant gave us very little if any significant MIS-C disease. In our facility, we have not seen a child with MIS-C-related heart disease probably for at least the last two months.”
One factor could be that more children are eligible for COVID-19 vaccines. Research shows that the Pfizer COVID-19 vaccine could reduce the risk of MIS-C in children by as much as 91 percent.
Other heart conditions – which can also be associated with MIS-C but are sometimes the result of acute COVID-19 infection – include myocarditis and pericarditis.
Myocarditis made headlines for appearing to be a rare complication of COVID-19 vaccinations. However, experts have noted the risk of developing myocarditis from an infection of COVID-19 is much higher than that of developing it from vaccination.
With myocarditis, “patients may present with mild symptoms of chest pain or can present with severe decompensated heart failure,” Dr. Elizabeth Profita, a pediatric cardiologist at Stanford Children’s Health in California, told Healthline.
However, “treatment of myocarditis is generally supportive care, and vaccination will prevent more hospitalizations and ICU admissions than it may cause myocarditis cases, even in adolescent males,” she added.
Other potential heart complications include cardiogenic shock, when a virus-weakened heart can’t pump sufficient blood, and heart arrhythmias, where heartbeats become irregular. Both are also rare.
“Long-term outcome data after SARS-CoV-2 infection are not yet available, but midterm data in children and youth are encouraging,” the statement authors write. “Early reports raised concern for significant cardiac complications after infection in youth. However, subsequent review of outcomes in young athletes indicates that a majority have had no adverse cardiac [conditions] after asymptomatic or mild infection.”
For parents, the best thing you can do if your child gets COVID-19 is to keep a sharp eye on them.
“Like any other disease, parents know their children very well,” Greissman said. “So an active toddler or child or young adult that’s going on with his typical activities, not fatigued, sleeping well, does not have a fever, kind of their baseline is very reassuring. What parents need to look out for is based on the initial problem they presented with.”
“Children who present with heart disease will typically be weaker after the recovery, get shortness of breath with exercise easier, and are easily fatigued,” he continued. “This should improve with time, but the parents need to watch to see if there’s any change in their ability to do their daily activities.”
Finally, if your child seems to develop new symptoms after COVID-19 has abated, it might be time to seek additional medical attention.
“There may be a subset of children who have persistent symptoms or develop new symptoms such as fatigue, difficulty catching their breath with minimal activity, palpitations, headaches that last for more one month who may be showing signs of long COVID,” Lee said. “If there is a concern for long COVID, I recommend speaking to a specialist. Thankfully, pediatric long COVID is relatively rare.”