Clinical Presentation and Outcomes of Myocarditis Among the COVID-19 Pediatric Population: A Review of 100 Cases.

Background: COVID-19 has been associated with myocarditis in the pediatric population, leading to severe cardiac complications.

Objective: To determine the clinical presentations and outcomes of myocarditis among the COVID-19-positive pediatric population.

Materials And Methods: This retrospective cross-sectional study included 100 cases from the Saidu Group of Teaching Hospitals, Swat. Inclusion criteria involved children of both genders, confirmed COVID-19 by PCR, and a myocarditis diagnosis. Exclusion criteria were other comorbid conditions, incomplete records, and age over five years. Data included age, gender, weight, clinical features, cardiac enzyme levels, ejection fraction, PCR results, immunoglobulin treatment, outcomes, and hospital stay duration. Statistical analysis was performed in SPSS employing descriptive statistics, chi-square tests, and Fisher's exact tests.

Results: The mean age was 24.72±18.67 months, with 67 males and 33 females. Irritability was noted in 18 children, cyanosis in 27, and cough in 74. Tachycardia was observed in 91 children. Elevated cardiac enzymes and positive Troponin-I levels were found in 91 and 84 children, respectively. The mean ejection fraction was 36.29±9.12%. The average hospital stay was 7.11±2.49 days. Among 100 children, 26 died while 74 recovered. Immunoglobulin administration showed no significant difference between the expired and improved groups (p=0.6). Longer hospital stays were associated with mortality (p=0.002). Troponin-I levels were significantly higher in the expired group (p=0.01).

Conclusion: Key factors associated with poor outcomes include low ejection fraction, elevated cardiac enzymes, positive Troponin-I levels, and shorter hospital stays.