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Are Kids with Congenital Heart Disease at Higher Risk for COVID-19?

Oct 07, 2020
Little girl wearing face mask

Congenital heart disease (CHD) refers to abnormalities of the heart which are present at birth. CHD is the most common birth defect, occurring in about 1 in every 100 births. If adults with underlying heart conditions are at increased risk for COVID-19, researchers wondered if the same would hold true for children. A study recently published in the Journal of the American Heart Association shows this isn’t necessarily the case.

Based on early experiences of heart disease centers, the study says that children with congenital heart disease are not at higher risk for getting COVID-19. Additionally, children who do get COVID-19 usually have less severe symptoms than adults and recover faster.

A very small percentage of children develop an illness that occurs several weeks after initial COVID-19 infection that can have more serious side effects on the heart, however. Multisystem inflammatory syndrome in children (MIS-C) is a serious illness that causes inflammation, or swelling, all throughout the body. It typically affects multiple organs, but commonly involves the heart.

Some features of MIS-C are similar to Kawasaki Disease but researchers still don’t know what predisposes a child to either. The good news is that when identified early and treated, the heart findings of MIS-C appear to resolve. This means that even if a child’s heart is weakened while they have MIS-C, as they recover, so does their heart. Once they leave the hospital, they will be followed by a multi-disciplinary team with specialists from the Kawasaki Team (cardiology and infectious disease), Heart Failure team, rheumatology, as well as others.

Researchers say there is still a lot we don’t know about COVID-19 and MIS-C. It does not appear that patients with congenital heart disease or a prior history of Kawasaki Disease are at a higher risk for developing MIS-C, but there are rare reports of this occurring. Ongoing studies are focused on COVID-19 in patients with congenital heart disease, Kawasaki Disease, as well as lasting outcomes for patients with MIS-C. For now, only time will tell what the long-term effects could be on the heart as well as the rest of the body from these conditions.   

If your child is experiencing symptoms of COVID-19, including fever, cough or difficulty breathing, or symptoms of MIS-C, which include persistent fever over 101°F, severe abdominal pain, diarrhea or rash that can’t be explained by another cause, call your child’s primary care provider right away.

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Simon Lee, MD
Simon Lee, MD

Dr. Simon Lee is an attending in The Heart Center, director of the Coronary Anomalies Program and co-director of the Kawasaki Disease Program.

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700 Children’s® features the most current pediatric health care information and research from our pediatric experts – physicians and specialists who have seen it all. Many of them are parents and bring a special understanding to what our patients and families experience. If you have a child – or care for a child – 700 Children’s was created especially for you.