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Nikhil Prasad  Fact checked by:Thailand Medical News Team Dec 22, 2023  2 months, 2 days, 16 hours, 55 minutes ago

COVID-19 News: Italian Pediatricians Warn That Infants Exposed To SARS-CoV-2 Typically Exhibit High levels Of Troponin!

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COVID-19 News: Italian Pediatricians Warn That Infants Exposed To SARS-CoV-2 Typically Exhibit High levels Of Troponin!
Nikhil Prasad  Fact checked by:Thailand Medical News Team Dec 22, 2023  2 months, 2 days, 16 hours, 55 minutes ago
COVID-19 News: The COVID-19 pandemic has brought forth numerous challenges, with varying degrees of severity across different age groups. While much attention has rightly been given to the impact of the SARS-CoV-2 virus on adults, a recent prospective comparative study conducted by the University of Naples "Federico II" and University Hospital Policlinico "Federico II" in Italy has raised concerns about the potential effects of the virus on infants. The study, covered in this COVID-19 News report, delves into the realm of pediatric COVID-19, specifically exploring the elevated troponin levels observed in infants exposed to the virus.


Most Infants Exposed To SARS-CoV-2 Have Elevated levels Of Troponin
 
Study Design and Sample
The study employed a multicentric three-arm comparative design, spanning the period from March 2020 to March 2022. The cohort included 152 infants hospitalized for COVID-19, 79 children with other acute infections, and 71 healthy controls. The primary objective was to investigate high sensitivity troponin (hs-cTn) levels, a marker of myocardial injury.
 
Results
The findings of the study unveiled a concerning pattern among infants with COVID-19, demonstrating significantly higher proportions of hs-cTn values above the upper limit of normal (28.9%) and a three-fold increased value (13.2%) compared to both control groups. This heightened risk of elevated hs-cTn was notably more pronounced in children with SARS-CoV-2 infection compared to healthy children or those with other infections.
 
Moreover, the study identified an association between hs-cTn elevation and infants below three months of age, suggesting a potential vulnerability in this age group. Surprisingly, no correlation was found between hs-cTn elevation and clinical or biochemical characteristics, nor perinatal risk factors. Despite the alarming nature of these findings, the study reported that all children exhibited a progressive reduction in hs-cTn levels over time, ultimately normalizing within one year of follow-up. Importantly, no clinical, ECG, or echocardiographic manifestations were observed during this follow-up period.
 
Discussion
The study's focus on myocardial injury in infants with acute SARS-CoV-2 infection addresses a critical gap in the existing literature. While myocardial involvement has been well-documented in adults with COVID-19, limited research has explored the extent of such complications in pediatric cases, particularly in infants.
 
The cardiovascular system emerges as a primary target of SARS-CoV-2 in children, evident in the elevated troponin levels observed. Troponin, a complex of regulatory proteins integral to muscle contraction in both cardiac and skeletal muscles, serves as a specific diagnostic marker for myocardial infarction and acute coronary syndrome. Sepsis, stroke, chronic kidney disease, pulmonary disease, heart failure, and stress cardiomyopathy can all raise serum troponin concentrations, and in some cases the elevations are pr ognostically important
 
The study underscores the specificity of troponin elevations in indicating cardiac trauma, which may be a result of the virus's impact on the cardiovascular system.
 
Conclusion
In conclusion, the Italian study raises crucial concerns about the potential impact of COVID-19 on infants, emphasizing elevated troponin levels as a marker of subclinical myocardial injury. While the study provides some reassurance by highlighting the transient nature of these alterations and the absence of immediate clinical consequences, it also underscores the need for vigilant monitoring.
 
The long-term effects of COVID-19 on cardiac health in infants remain uncertain, necessitating continued research and comprehensive follow-up studies. Pediatricians and healthcare professionals should remain alert to the potential risks associated with SARS-CoV-2 exposure in infants, especially during the first months of life. Ongoing research will be instrumental in unraveling the full spectrum of COVID-19's impact on pediatric cardiovascular health, ultimately informing preventive and therapeutic strategies tailored to this vulnerable population.
 
The study findings were published as a pre-proof in the peer reviewed Journal of Pediatrics.
https://www.sciencedirect.com/science/article/abs/pii/S0022347623007400
 
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