Myocarditis Associated with Coronavirus Disease 2019 (COVID-19) in a Pediatric Patient

摘要

Viral infection is one of the most important causes of myocarditis both in adult and pediatric age. We describe acute myocarditis due to SARS-CoV-2 infection in an otherwise healthy 12-years-old Caucasian boy. He was admitted because of a history of 2 days of fever, dry cough, diarrhea, abdominal pain and fatigue. In spite of a family history of COVID-19 patient strict contact, a first nasopharyngeal swab for SARS-CoV-2 RNA resulted negative. After 4 days, his clinical condition evolved, with the onset of interstitial pneumonia, as documented by chest tomography and tachycardia. Blood analysis showed an NTproBNP and TnT increasing, transthoracic echocardiography revealed normal left ventricle (LV) dimension, altered myocardial texture, diffuse hypokinesis and impaired left ventricular function. A nasopharyngeal swab tested positive for SARS-CoV-2 infection at day 6 after admission. Heart failure conventional treatment associated with heparin, glucocorticoids and Remdesivir were administered with progressive improvement of clinical and instrumental conditions. No residual heart damage was documented during the following 3 monthes cardiological outpatient follow-up. Although COVID-19 infection has a milder course of disease in children than in adults, severe forms of the disease may occur and myocarditis should be carefully considered in the pediatric age.