TY - JOUR
T1 - Cardiovascular post-acute sequelae of SARS-CoV-2 in children and adolescents
T2 - cohort study using electronic health records
AU - Zhang, Bingyu
AU - Thacker, Deepika
AU - Zhou, Ting
AU - Zhang, Dazheng
AU - Lei, Yuqing
AU - Chen, Jiajie
AU - Chrischilles, Elizabeth A.
AU - Christakis, Dimitri A.
AU - Fernandez, Soledad
AU - Garg, Vidu
AU - Kim, Susan
AU - Mosa, Abu S.M.
AU - Sills, Marion R.
AU - Taylor, Bradley W.
AU - Williams, David A.
AU - Wu, Qiong
AU - Forrest, Christopher B.
AU - Chen, Yong
N1 - Publisher Copyright:
© The Author(s) 2025.
PY - 2025/4/11
Y1 - 2025/4/11
N2 - The risk of cardiovascular outcomes following SARS-CoV-2 infection has been reported in adults, but evidence in children and adolescents is limited. This paper assessed the risk of a multitude of cardiac signs, symptoms, and conditions 28-179 days after infection, with outcomes stratified by the presence of congenital heart defects (CHDs), using electronic health records (EHR) data from 19 children’s hospitals and health institutions from the United States within the RECOVER consortium between March 2020 and September 2023. The cohort included 297,920 SARS-CoV-2-positive individuals and 915,402 SARS-CoV-2-negative controls. Every individual had at least a six-month follow-up after cohort entry. Here we show that children and adolescents with prior SARS-CoV-2 infection are at a statistically significant increased risk of various cardiovascular outcomes, including hypertension, ventricular arrhythmias, myocarditis, heart failure, cardiomyopathy, cardiac arrest, thromboembolism, chest pain, and palpitations, compared to uninfected controls. These findings were consistent among patients with and without CHDs. Awareness of the heightened risk of cardiovascular disorders after SARS-CoV-2 infection can lead to timely referrals, diagnostic evaluations, and management to mitigate long-term cardiovascular complications in children and adolescents.
AB - The risk of cardiovascular outcomes following SARS-CoV-2 infection has been reported in adults, but evidence in children and adolescents is limited. This paper assessed the risk of a multitude of cardiac signs, symptoms, and conditions 28-179 days after infection, with outcomes stratified by the presence of congenital heart defects (CHDs), using electronic health records (EHR) data from 19 children’s hospitals and health institutions from the United States within the RECOVER consortium between March 2020 and September 2023. The cohort included 297,920 SARS-CoV-2-positive individuals and 915,402 SARS-CoV-2-negative controls. Every individual had at least a six-month follow-up after cohort entry. Here we show that children and adolescents with prior SARS-CoV-2 infection are at a statistically significant increased risk of various cardiovascular outcomes, including hypertension, ventricular arrhythmias, myocarditis, heart failure, cardiomyopathy, cardiac arrest, thromboembolism, chest pain, and palpitations, compared to uninfected controls. These findings were consistent among patients with and without CHDs. Awareness of the heightened risk of cardiovascular disorders after SARS-CoV-2 infection can lead to timely referrals, diagnostic evaluations, and management to mitigate long-term cardiovascular complications in children and adolescents.
KW - Humans
KW - Adolescent
KW - COVID-19/complications
KW - Child
KW - Electronic Health Records
KW - Male
KW - Female
KW - Cardiovascular Diseases/epidemiology
KW - Child, Preschool
KW - SARS-CoV-2
KW - Heart Defects, Congenital/epidemiology
KW - Cohort Studies
KW - Infant
KW - United States/epidemiology
KW - Risk Factors
UR - https://www.scopus.com/pages/publications/105002971705
U2 - 10.1038/s41467-025-56284-0
DO - 10.1038/s41467-025-56284-0
M3 - Article
C2 - 40216777
AN - SCOPUS:105002971705
SN - 2041-1723
VL - 16
SP - 3445
JO - Nature Communications
JF - Nature Communications
IS - 1
M1 - 3445
ER -