By Cara Murez
The report was published Dec. 2 in the journal JACC: Case Reports.
"The presentation and clinical course of this patient mirrors four case reports of acute myocardial injury reported in adult patients with COVID-19," said Dr. Madhu Sharma, lead author of the case report and a pediatric cardiologist at The Children's Hospital at Montefiore in New York City.
"Most children with COVID-19 are either asymptomatic or have mild symptoms, but our case shows the potential for reversible myocardial injury in infants with COVID-19," Sharma said in a journal news release. "Testing for COVID-19 in children presenting with signs and symptoms of heart failure is very important as we learn more about the impact of this virus."
The infant in this case was choking and had bluish discoloration of the skin after feeding, but did not have fever, cough, upper respiratory tract infection symptoms, diarrhea, vomiting or decreased feeding prior to that.
An initial COVID-19 test was negative, but a follow-up test was positive. An ECG showed a heart injury due to viral infection and heart failure symptoms that were exacerbated by a viral infection. Tests ruled out all other causes for these heart issues.
The baby's care included the medication remdesivir under a compassionate-use order, the use of a ventilator for respiratory failure, a low blood pressure treatment and fluids. The infant had been born prematurely at 33 weeks and stayed in the NICU for three weeks at that time, including one week with a treatment that helped with breathing.
This myocardial injury has been seen in some adult patients since the earliest reports of COVID-19, according to the new research, with as many as 20% to 28% showing evidence of this injury in early groups of adult patients. Most patients with this type of injury had preexisting cardiovascular disease.
The U.S. Centers for Disease Control and Prevention offers more on COVID-19 and children.
SOURCE: JACC: Case Reports, news release, Dec. 2, 2020