{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:14:37Z","timestamp":1753892077602,"version":"3.41.2"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T00:00:00Z","timestamp":1630972800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Identifying the cardiac changes could help design measures to recover the cardiovascular system and lessen the mortality and morbidity rate. Accordingly, this cross-sectional study was performed to evaluate the echocardiography indices which are indicators of the cardiac alterations of the children with COVID19 infection.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> This study was performed as a cross-sectional study evaluating echocardiography indices in children infected with COVID19. Fifteen children, known cases of the COVID19, and 14 healthy children were enrolled. Evaluated parameters include left ventricle ejection fraction (LVEF), left ventricle end-diastolic diameter (LVED), mitral valve Sa (MV Sa), Tricuspid annular plane systolic excursion (TAPSE), and laboratory parameters.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The participants' mean age and weight were 62.8 (\u00b148.0) months and 19.95 (\u00b115.67) kg, respectively. None of the laboratory and echocardiography parameters differed between males and females, between patients with and without positive past medical history, between the patients with and without respiratory tract symptoms, and between patients with and without GI tract symptoms (P.0.05). Patients had significantly higher TAPSE (<jats:italic>p<\/jats:italic> = 0.027), although MV Sa (<jats:italic>p<\/jats:italic> = 0.01) was significantly higher among healthy children. LV EF (<jats:italic>p<\/jats:italic> = 0.425) and LVED diameter (<jats:italic>p<\/jats:italic> = 0.603) were not different significantly. None of the patients had pericardial effusion, pleural effusion, and cardiac tamponade.<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> The heart can be involved during the disease course in children, even at the level of echocardiography indices. This could contribute to a worse prognosis, higher morbidity, and mortality rate, especially in patients with overt myocardial involvement. Non-classic indicators, including LVEF, may not be conclusive for cardiac involvement in non-symptomatic patients.<\/jats:p>","DOI":"10.3389\/fped.2021.697213","type":"journal-article","created":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T05:15:04Z","timestamp":1630991704000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Little Hearts Are Affected by COVID19: Importance of the Myocardial Systolic Evaluation"],"prefix":"10.3389","volume":"9","author":[{"given":"Setareh","family":"Mamishi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aliakbar","family":"Zeinaloo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elmira","family":"Haji Esmaeil Memar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahmoud","family":"Khodabandeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Reza","family":"Mirzaaghayan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Reza","family":"Abdolsalehi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamid","family":"Eshaghi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mojtaba","family":"Gorji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Azin","family":"Ghamari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ehsan","family":"Aghaei Moghadam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2021,9,7]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"106024","DOI":"10.1016\/j.ijantimicag.2020.106024","article-title":"Extra-respiratory manifestations of COVID-19","volume":"2020","author":"Lai","year":"2020","journal-title":"Int J Antimicrob Agents"},{"key":"B2","doi-asserted-by":"publisher","first-page":"177","DOI":"10.23750\/bm.v91i2.9655","article-title":"COVID19: potential cardiovascular issues in pediatric patients","volume":"91","author":"Bertoncelli","year":"2020","journal-title":"Acta Bio Med Atenei Parmensis."},{"key":"B3","doi-asserted-by":"publisher","first-page":"973","DOI":"10.1016\/j.hlc.2020.05.101","article-title":"SARS-CoV-2 infection and cardiovascular disease: COVID-19 heart","volume":"29","author":"Dhakal","year":"2020","journal-title":"Heart Lung Circ."},{"key":"B4","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1016\/S2213-2600(20)30152-1","article-title":"COVID-19 infection in children","volume":"8","author":"Sinha","year":"2020","journal-title":"Lancet Respir Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1016\/j.jmii.2020.02.011","article-title":"Are children less susceptible to COVID-19?","volume":"53","author":"Lee","year":"2020","journal-title":"J Microbiol Immunol Infect."},{"key":"B6","doi-asserted-by":"publisher","first-page":"982","DOI":"10.1016\/j.jfma.2020.04.007","article-title":"Clinical characteristics and diagnostic challenges of pediatric COVID-19: a systematic review and meta-analysis","volume":"119","author":"Chang","year":"2020","journal-title":"J Formosan Med Assoc."},{"key":"B7","doi-asserted-by":"publisher","first-page":"662","DOI":"10.1016\/S2352-4642(20)30175-9","article-title":"Emergence of Kawasaki disease related to SARS-CoV-2 infection in an epicentre of the French COVID-19 epidemic: a time-series analysis","volume":"4","author":"Ouldali","year":"2020","journal-title":"Lancet Child Adolesc Health."},{"key":"B8","doi-asserted-by":"publisher","first-page":"117723","DOI":"10.1016\/j.lfs.2020.117723","article-title":"Myocardial injury and COVID-19: possible mechanisms","volume":"2020","author":"Babapoor-Farrokhran","year":"2020","journal-title":"Life Sci"},{"key":"B9","doi-asserted-by":"publisher","first-page":"110230","DOI":"10.1016\/j.biopha.2020.110230","article-title":"Advances in the relationship between coronavirus infection and cardiovascular diseases","volume":"2020","author":"Zhao","year":"2020","journal-title":"Biomed Pharmacother"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1267","DOI":"10.1016\/j.jaccas.2020.05.082","article-title":"Cardiac dysfunction and shock in pediatric patients with COVID-19","volume":"2","author":"Joshi","year":"2020","journal-title":"JACC Case Rep."},{"key":"B11","doi-asserted-by":"publisher","first-page":"fmaa045","DOI":"10.1093\/tropej\/fmaa045","article-title":"Radiological findings of COVID-19 in children: a systematic review and meta-analysis","volume":"67","author":"Kumar","year":"2021","journal-title":"J Trop Pediatr."},{"key":"B12","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1213\/ANE.0000000000001048","article-title":"Intermittent hypoxia causes inflammation and injury to human adult cardiac myocytes","volume":"122","author":"Wu","year":"2016","journal-title":"Anesthes Analgesia."},{"key":"B13","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1001\/jama.2020.1585","article-title":"Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China","volume":"323","author":"Wang","year":"2020","journal-title":"JAMA."},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.2139\/ssrn.3556659","article-title":"Clinical characteristics and cardiac injury description of 419 cases of COVID-19 in Shenzhen, China","author":"Zeng","year":"2020"},{"key":"B15","doi-asserted-by":"publisher","first-page":"146","DOI":"10.1542\/peds.2020-1509","article-title":"Acute fulminant myocarditis in a pediatric patient with COVID-19 infection","author":"Lara","year":"2020","journal-title":"Pediatrics."},{"key":"B16","doi-asserted-by":"publisher","first-page":"e204","DOI":"10.1097\/INF.0000000000002788","article-title":"COVID-19-associated myocarditis in an adolescent","volume":"39","author":"Trogen","year":"2020","journal-title":"Pediatr Infect Dis J."},{"volume-title":"Systemic Risk of Pandemic via Novel Pathogens-Coronavirus: A Note","year":"2020","author":"Norman","key":"B17"},{"key":"B18","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/j.ijcard.2016.10.009","article-title":"TAPSE: an old but useful tool in different diseases","volume":"225","author":"Aloia","year":"2016","journal-title":"Int J Cardiol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"1463","DOI":"10.1016\/j.hrthm.2020.05.001","article-title":"Recognizing COVID-19-related myocarditis: the possible pathophysiology and proposed guideline for diagnosis and management","volume":"17","author":"Siripanthong","year":"2020","journal-title":"Heart Rhythm."},{"key":"B20","doi-asserted-by":"publisher","first-page":"773","DOI":"10.20944\/preprints202003.0180.v1","article-title":"First case of COVID-19 infection with fulminant myocarditis complication: case report and insights","volume":"48","author":"Zeng","year":"2020","journal-title":"Infection"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00246-020-02391-2","article-title":"Paediatric inflammatory multisystem syndrome: temporally associated with SARS-CoV-2 (PIMS-TS): cardiac features, management and short-term outcomes at a UK Tertiary Paediatric Hospital","volume":"2020","author":"Ramcharan","year":"2020","journal-title":"Pediatr Cardiol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"2287","DOI":"10.1016\/j.jcmg.2020.04.014","article-title":"Prognostic value of right ventricular longitudinal strain in patients with COVID-19","volume":"13","author":"Li","year":"2020","journal-title":"JACC Cardiovasc Imaging."},{"journal-title":"Partner Updates: Case Definition for MISC-C","year":"","key":"B23"},{"article-title":"Multisystem inflammatory syndrome in children (MIS-C) with COVID-19","year":"","author":"Pudjiadi","key":"B24"},{"key":"B25","doi-asserted-by":"publisher","first-page":"eabf7570","DOI":"10.1126\/sciimmunol.abf7570","article-title":"Deep immune profiling of MIS-C demonstrates marked but transient immune activation compared to adult and pediatric COVID-19","volume":"6","author":"Vella","year":"2021","journal-title":"Science Immunol."},{"key":"B26","doi-asserted-by":"publisher","first-page":"1947","DOI":"10.1016\/j.jacc.2020.08.056","article-title":"Echocardiographic findings in pediatric multisystem inflammatory syndrome associated with COVID-19 in the United States","volume":"76","author":"Matsubara","year":"2020","journal-title":"J Am Coll Cardiol."}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2021.697213\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T05:15:08Z","timestamp":1630991708000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2021.697213\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,9,7]]},"references-count":26,"alternative-id":["10.3389\/fped.2021.697213"],"URL":"https:\/\/doi.org\/10.3389\/fped.2021.697213","relation":{},"ISSN":["2296-2360"],"issn-type":[{"type":"electronic","value":"2296-2360"}],"subject":[],"published":{"date-parts":[[2021,9,7]]},"article-number":"697213"}}