儿童新型冠状病毒感染相关心肌损害/心肌炎临床特点

Clinical characteristics of COVID-19 associated myoc-ardial injury/myocarditis in children

新型冠状病毒肺炎(COVID-19)可直接和间接影响心血管系统,相关机制包括病毒直接侵袭、炎症因子风暴、低氧血症导致的心肌缺氧损伤及免疫紊乱等多种机制。儿童新型冠状病毒感染可导致心肌损伤、心肌炎、心律失常及多系统炎症综合征等心血管并发症。相对于其他病毒性心肌病,COVID-19相关病例起病更隐匿,发生暴发性心肌炎比例更多,且感染期过后仍存在持续性症状。另外,既往有心血管基础疾病的COVID-19患儿预后更差。文章综述了儿童新型冠状病毒感染相关心肌损害/心肌炎临床特点、相关机制及管理要点。

COVID-19 might have a direct and indirect effect on the cardiovascular system.The relevant mechanisms include virus direct invasion,inflammatory factor storm,hypoxemia induced myocardial hypoxia injury and immune disorders.Novel coronavirus infection in children can lead to cardiovascular complications such as myocardial damage,myocarditis,arrhythmia and multi-system inflammatory syndrome.Compared with other viral cardiomyopathies,COVID-19 related cases have a more insidious onset,a higher proportion of fulminant myocarditis,and persistent symptoms after the infection period.In addition,children with COVID-19 who have pre-existing underlying cardiovascular disease have a worse prognosis than previously healthy children.This article reviews the clinical features,mechanisms and management of novel coronavirus infection-related myocardial damage/myocarditis in children.