Cardiovascular post-acute sequelae of SARS-CoV-2 in children and adolescents: Cohort study using electronic health records
Zhang, B; Thacker, D; Zhou, T; et al., Nature Communications
Published
April 2025
Journal
Nature Communications
Abstract
The risk of cardiovascular outcomes following SARS-CoV-2 infection has been reported in adults, but evidence in children and adolescents is limited. This paper assessed the risk of a multitude of cardiac signs, symptoms, and conditions 28-179 days after infection, with outcomes stratified by the presence of congenital heart defects (CHDs), using electronic health records (EHR) data from 19 children's hospitals and health institutions from the United States within the RECOVER consortium between March 2020 and September 2023. The cohort included 297,920 SARS-CoV-2-positive individuals and 915,402 SARS-CoV-2-negative controls. Every individual had at least a six-month follow-up after cohort entry. Here we show that children and adolescents with prior SARS-CoV-2 infection are at a statistically significant increased risk of various cardiovascular outcomes, including hypertension, ventricular arrhythmias, myocarditis, heart failure, cardiomyopathy, cardiac arrest, thromboembolism, chest pain, and palpitations, compared to uninfected controls. These findings were consistent among patients with and without CHDs. Awareness of the heightened risk of cardiovascular disorders after SARS-CoV-2 infection can lead to timely referrals, diagnostic evaluations, and management to mitigate long-term cardiovascular complications in children and adolescents.
Authors
Bingyu Zhang, Deepika Thacker, Ting Zhou, Dazheng Zhang, Yuqing Lei, Jiajie Chen, Elizabeth A Chrischilles, Dimitri A Christakis, Soledad Fernandez, Vidu Garg, Susan Kim, Abu S M Mosa, Marion R Sills, Bradley W Taylor, David A Williams, Qiong Wu, Christopher B Forrest, Yong Chen
Keywords
Humans; Adolescent; COVID-19/complications/epidemiology/virology; Child; Electronic Health Records; Male; Female; Cardiovascular Diseases/epidemiology/etiology; Child, Preschool; SARS-CoV-2; Heart Defects, Congenital/epidemiology/complications; Cohort Studies; Infant; United States/epidemiology; Risk Factors
Short Summary
This RECOVER study looked at electronic health records (EHRs) from almost 300,000 children and young adults ages 20 and younger who had COVID-19 and compared them to over 900,000 children and young adults who did not. Researchers wanted to find out if there was a higher chance of heart problems for children and young adults—a symptom of Long COVID in this age group—after they had COVID-19. They found that children and young adults who had COVID-19 were much more likely to have heart problems like high blood pressure, heart inflammation, chest pain, and a fast heartbeat. These increased risks were found in all children and young adults, whether they had a heart condition before getting COVID-19 or not. This study is important for doctors so they can check and treat children and young adults for heart problems after COVID-19.