Koronavirüs Hastalığı 2019 (COVID-19) Nedeniyle Miyokardit Gelişen Çocukların Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, Koronavirüs hastalığı 2019 (COVID-19) nedeniyle miyokardit gelişen hastaların verilerini paylaşmaktır.

Materyal ve metod: Nisan 2020 ile Ocak 2022 tarihleri arasında COVID-19’a bağlı miyokardit tanısı alan 50 çocuğun verileri retrospektif olarak değerlendirildi.

Bulgular: Hastaların 24’ünde (%48) multisistem inflamatuar sendrom (MIS-C) saptandı. En sık görülen yakınmalar ateş (26 hasta, %52) ve göğüs ağrısı (14 hasta, %28) idi. Sekiz hastada (%16) sistolik disfonksiyon mevcuttu. Bir hastaya kardiyak tamponad nedeniyle perikardiyosentez yapıldı. Dört hastada (%8) akut fulminan miyokardit gelişti ve yoğun bakım gereksinimi oldu. Bir hasta entübasyona ihtiyaç duydu ve sonrasında ekstübe edildi. Yirmi bir hasta (%42) yalnızca intravenöz immünoglobulin ile tedavi edildi, 8 hasta intravenöz immünoglobulin + steroid aldı. Dört hastaya (%8) intravenöz inotropik tedavi uygulandı. Yirmi bir hasta (%42) ise herhangi bir tedavi almadan sadece yatak istirahati ile iyileşti. Hiçbir hastamız kaybedilmedi.

Sonuç: Çalışmamızda, COVID-19’a bağlı miyokardit gelişen pediatrik hastaların yaklaşık yarısının yalnızca yatak istirahati ile iyileştiği görüldü. Bununla birlikte, çalışmamızın da gösterdiği gibi bazı olgularda fulminan miyokardite ilerleyebilmektedir. Bu nedenle, bu tür hastalar stabil görünseler bile yakından izlenmelidir; çünkü uygun tedavi, ihtiyaç duyan hastalara hızlıca uygulandığında mortalite büyük ölçüde önlenebilmektedir.

Keywords

• Çocuklar
• Koronavirüs Hastalığı 2019 (COVID-19)
• Miyokardit
• Fulminan

Evaluation of Children Who Develop Myocarditis Due to Coronavirus Disease 2019

Abstract

Background: The aim of this study is to share the data of patients who developed myocarditis due to Coronavirus disease 2019 (COVID-19).

Materials and Methods: The data of 50 children who were diagnosed with myocarditis due to Coronavirus disease 19 between April 2020 and January 2022 were retrospectively evaluated.

Results: Twenty-four (48%) of the patients were diagnosed with multisystem inflammatory syndrome (MIS-C). Twenty-six (52%) patients had fever and 14 (28%) patients had chest pain, which were the most common complaints. Eight (16%) patients had systolic dysfunction. Pericardiocentesis was performed in one patient due to cardiac tamponade. In four (8%) of the patients, acute fulminant myocarditis developed and intensive care was required. One patient required intubation and was later extubated. Twenty-one (42%) patients were treated with intravenous immunoglobulin alone, and 8 patients were treated with intravenous immunoglobulin + steroids. Four (8%) patients received intravenous inotropic therapy. Twenty-one (42%) patients did not receive any treatment and recovered with bed rest only. None of our patients died.

Conclusions: In our study, approximately half of the pediatric patients who had developed myocarditis due to Coronavirus disease 2019 recovered with bed rest only. However, as shown in our study, it may progress to fulminant myocarditis in some patients. Therefore, even if such patients are stable, they need to be followed up closely since mortality can be prevented at a high rate when the appropriate treatments are rapidly provided to patients in need.

Keywords

• Children
• Coronavirus Disease 2019
• Myocarditis
• FulminantCorresponding

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