Elevated Cardiac Biomarkers and Outcomes in Children and Adolescents with Acute COVID-19

Michael A. Fremed, Emma W. Healy, Nak Hyun Choi, Eva W. Cheung, Tarif A. Choudhury, Pengfei Jiang, Leonardo Liberman, Jason Zucker, Irene D. Lytrivi, Thomas J. Starc

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1 Scopus citations


Cardiac involvement associated with multi-system inflammatory syndrome in children (MIS-C) has been extensively reported, but the prevalence of cardiac involvement in children with SARS-CoV-2 infection in the absence of inflammatory syndrome has not been well described. In this retrospective, single center, cohort study, we describe the cardiac involvement found in this population and report on outcomes of patients with and without elevated cardiac biomarkers. Those with MIS-C, cardiomyopathy, or complex congenital heart disease were excluded. Inclusion criteria were met by 80 patients during the initial peak of the pandemic at our institution. High-sensitivity troponin T and/or NT-proBNP were measured in 27/80 (34%) patients and abnormalities were present in 5/27 (19%), all of whom had underlying comorbidities. Advanced respiratory support was required in all patients with elevated cardiac biomarkers. Electrocardiographic abnormalities were identified in 14/38 (37%) studies. Echocardiograms were performed on 7/80 subjects, and none demonstrated left ventricular dysfunction. Larger studies to determine the true extent of cardiac involvement in children with COVID-19 would be useful to guide recommendations for standard workup and management.

Original languageEnglish
JournalCardiology in the Young
StateAccepted/In press - 2022
Externally publishedYes


  • COVID-19
  • Cardiac
  • Multisystem inflammatory syndrome in children
  • Outcomes


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