Computational Analysis of Cardiovascular Effects of COVID-19 Infection in Children

Abstract

Background: The COVID-19 disease can involve any body part; nevertheless, the most serious consequences affect respiratory and cardiocirculatory systems with variable symptoms. Although the effects of COVID-19 are not fully understood yet, clinical evidence has shown that the virus may cause acute myocardial injury and chronic damages to heart and blood vessels. There is no or limited experience on pathophysiological effects of COVID-19 infection in children’s cardiovascular system. The aim of this work is to assess the effects of COVID-19 on the cardiovascular system in children, in terms, e.g., of increased pulmonary resistances, reduced cardiac contraction capacity. Methods: We used a computational model based on lumped parameters to describe the whole blood circulation. The model was calibrated to account for data coming from pediatric patients. Results: There were total of 17 pediatric patients diagnosed to have COVID-19 infection based on laboratory and clinical findings. The median age was 15 years (range 7 to 17 years), median weight 61 kg (range 25 to 153 kg), median height 165 cm (range 132 to 191 cm) and median body surface area 1.7 (range 0.95 to 2.8). Our results highlighted that the effect of COVID-19 on the cardiovascular system in all children was characterized by the reduction in cardiac blood pressures and volumes. We analyzed in detail two patients showing a correlation between myocardial compromise and severity of the infection. Conclusion: Our study demonstrates that COVID-19 infection causes a complex pathophysiological state to the cardiovascular system, both in asymptomatic and symptomatic pediatric patients. This information is very helpful to prevent long term cardiovascular complications of COVID-19 infection in children. A prospective study with regular cardiology follow-up is recommended.