PD165 - HIGH CARDIAC TROPONIN LEVELS IN INFANTS WITH ACUTE SARS-COV-2 INFECTION NOT FULFILLING CRITERIA OF MULTISYSTEMIC INFLAMMATORY SYNDROME: A COMPARATIVE STUDY (ID 1501)
Abstract
Backgrounds:
COVID-19 in children has milder disease course and better prognosis than in adults. Cardiovascular system is one of the potential targets of SARS-CoV-2 infection, either in adults or children. Myocardial injury has been reported in children with multisystem inflammatory syndrome and sporadically during acute SARS-CoV-2 infection.
Methods
In order to investigate the role of SARS-CoV-2 in inducing a myocardial injury, we conducted a prospective comparative cohort study (March 25th 2020 to October 20th 2021) enrolling children <24 months hospitalized for COVID-19 (group A), acute infections other than SARS-CoV-2 (group B) compared to healthy controls (group C). The value of high-sensitivity cardiac Troponin (hs-cTn) was considered as primary outcome.
Results:
Mean value of hs-cTn was significantly higher in group A (50.5±136.1 pg/ml [0-1038]) than in group B (9.4±30.6 [0-165]) and C (20.4±17.0 [6-181]) (p<0.0001). In children with COVID-19, age < 3 months was significantly associated with positive hs-cTn (p=0.0001) and highest hs-cTn values (372.4±397.9 pg/mL) were recorded in median 4.5 days from symptoms’ onset, resulting in a 3 to 30-fold increase over local threshold. Hs-cTn levels progressively returned within the normal ranges after a median follow-up of 90 days, without clinical sings, ECG alteration or impairment of cardiac function.
Conclusions/Learning Points:
Our findings support the hypothesis that SARS-CoV-2 may have an early, probably transitory infiltration in myocardial tissue in a number of young infants with COVID-19, not fulfilling MIS-C criteria. Although the elevation of troponin was not associated with cardiac function impairment and normalized within three months of follow-up, long-term consequences are unknown and might need further assessment of longer follow-up.
