The Cardiac Effects of Severe Acute Respiratory Syndrome Corona virus 2 (SARS-CoV-2) [COVID-19] Infection in Children and Young Adults

Thyyar M Ravindranath

Division of Pediatric Critical Care Medicine, Department of Pediatrics, Morgan Stanley Children’s Hospital of New York-Presbyteri, Columbia university Irving Medical Center 

Correspondence: Thyyar M Ravindranath, Senior Lecturer, Division of Pediatric Critical Care Medicine, Department of Pediatrics, Morgan Stanley Children’s Hospital of New York-Presbyterian, Columbia University Irving Medical Center, Vagelos College of Physicians and Surgeons, 630 West 168th Street, New York, New York-10032, USA. Email [email protected] 

Received: October 13, 2023                                                                                                                              Published: October 28, 2023

Citation: Thyyar M Ravindranath. The Cardiac Effects of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) [COVID-19] Infection in Children and Young Adults. AOJ Emerg and Int Med. 2023;1(1):39–42. 

Copyright: ©2023 Thyyar M Ravindranath. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and build upon your work non-commercially

Abstract 

SARS-COV-2, although it causes less serious infection in children and young adults than in older adults, it does trigger morbidity and mortality. SARS-COV-2 can present in one of the two ways, either as an acute infection or as Multi System Inflammatory Syndrome in children (MIS-C). Both scenarios can be differentiated on clinical grounds. MIS-C also must be differentiated from Kawasaki disease (KD). A few children require hospitalization, some even require care in the critical care unit. Vaccination helps to prevent serious infection and hospitalization.

Keywords: COVID-19, MIS-C, KD, inflammation, vaccination, pharmacological agents

Introduction 

As per the CDC, COVID-19 infection in the pediatric age group of 18 years and below afflicted 17.6% of the total cases with a mortality rate of 0.1%. On the other hand, young adults made up 21% of total cases with a mortality rate of 0.8%.1 Those children with comorbid conditions such as obesity, an immunocompromised state, and chronic pulmonary disease are at risk for increased hospitalization, admission into critical care unit, and death.2 

MIS-C is an inflammatory disorder that follows 2-6 weeks after COVID-19 infection3 and affects multiple organs, occurring in 1 in 3164 cases of COVID-19 infection.4 It is seen more in non-Hispanic black children, Hispanic children and less in non-Hispanic white and Asian children.5 

Pathogenesis: 

SARS-COV-2 is an RNA virus whose spike protein (Sprotein) has a great affinity for Angiotensin Converting Enzyme-2 receptor (ACE-2) which is found on the surface of the host cell and therefore can easily binds to the Sprotein.6 The virus entry into the type-2 alveolar epithelial cell is facilitated by the host’s serine protease which cleaves ACE-2 and thus activates the viral protein.7 

The mechanism of cardiac injury6 is due to 

1. Direct injury by the virus, 

2. Severe proinflammatory response leading to injury by cytokines generated because of inflammation,

3. Hypoxic-ischemic damage. 

However certain factors such as lower ACE-2 receptor in the heart, frequent viral infections, immunizations, and different cytokine response in children act as a protective influence for less severe infection following SARS-COV-2