The Relationship Between COVID-19 in Children and Vascular Changes

In children, history of SARS-CoV-2 infection is not associated with vascular changes, according to study results presented at the American College of Cardiology (ACC) 2023 Conference, held from March 4 to 6, 2023, in New Orleans, Louisiana.

Researchers sought to identify evidence of vascular disease post-COVID-19 infection in children by comparing arterial stiffness and carotid intima media thickness (IMT) in healthy control patients and pediatric patients with a prior SARS-CoV-2 infection.

A total of 234 children comprised the study population. Of them, 155 patients had a history of COVID-19. Of these 155 children (Group 1), 105 had mild symptoms and recovered at home, 40 had moderate to severe symptoms and required hospitalization, and 10 experienced multisystem inflammatory syndrome in children (MIS-C). Group 2 included 79 control patients with negative SARS-CoV-2 immunoglobulin G antibodies.

Anthropometric measurements, inflammatory markers, and lipid profiles were obtained from the children in both groups. IMT in the carotid arteries was evaluated, and aortic pulse wave velocity (PWV) and augmentation index (AxI) were calculated.

The participants in Group 1, who were evaluated from 2 months to 1 year following COVID-19 infection, were significantly older than patients in Group 2 (mean age, 10.8±3.2 years vs 8.5±2.8 years, respectively; P <.001) and had a higher body mass index (BMI; 20.3±5.6 kg/m² vs 18.4±3.5 kg/m², respectively; P <.001). Significant increases in systolic blood pressure were also reported in Group 1 compared with Group 2 (118.9±10.4 mm Hg vs 114.1±8.8 mm Hg, respectively; P <.001), as well as increases in PWV (5.02±0.7 m/sec vs 4.7±0.6 m/sec, respectively; P <.001).

Children in Group 1 with severe SARS-CoV-2 infection had a significantly higher PWV compared with those with mild COVID-19 (coefficient, 0.5; 95% CI, 0.3-0.7; P <.001); however, no difference was observed in the post–MIS-C group.

The vascular changes reported between the groups were eliminated when differences in age, BMI, and blood pressure were taken into consideration. Further, no differences in mean IMT and AxL were observed between the groups, and cholesterol levels and inflammatory markers were comparable as well.

“Our study demonstrates that history of SARS-CoV-2 infection is not associated with vascular changes in contrast to adult reports,” the authors wrote. “These data argue against increased long-term vascular risk in children post-SARS-CoV-2 infection.”