Although COVID-19 is mostly a disease affecting the respiratory system, there are reports of children with the virus sustaining heart damage.

If your child had moderate to severe COVID-19 symptoms, a screening to determine possible heart complications should be considered. With many youngsters returning to competitive sports, it is important for parents to remain aware.

Dr. Matthew Brothers

“From a cardiac standpoint, the main fears are that COVID-19 can cause some myocarditis which is inflammation of the heart, and a condition called multisystem inflammatory syndrome, which can have cardiac involvement as well,” said Dr. Matthew Brothers of Novant Health Pediatric Cardiology.

Multisystem inflammatory syndrome in children (MIS-C), believed to be linked to COVID-19, can damage the heart to such an extent that some children will need lifelong monitoring. MIS-C is a rare, but severe condition that has been reported two to four weeks after the onset of COVID-19 in children and adolescents.


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MIS-C is a condition where different body parts can become inflamed, including the heart, lungs, kidneys, brain, skin, eyes, or gastrointestinal organs. Children with MIS-C may have a fever and various symptoms, including abdominal pain, vomiting, diarrhea, neck pain, rash, bloodshot eyes, or feeling extremely tired.

It isn’t known which patient will develop MIS-C. However, many children with MIS-C had the virus that causes COVID-19, or had been around someone with COVID-19.

If your child had mild COVID-19 symptoms, recovered and has been asymptomatic for at least 14 days, they probably can return to physical activity without an extensive heart evaluation, Brothers said.

If your athletic child is over 12 and had moderate COVID-19 , Brothers suggested at least an electrocardiogram (EKG) to evaluate. In some cases, an echocardiogram is administered.

“Children who were hospitalized with severe symptoms of COVID-19 get a complete extensive evaluation to assess for damage to the heart muscle,” Brothers said. “We treat them as if they have myocarditis. They get laboratory work done, they get imaging, and they get held out of sports for three to six months, depending on the situation.”

As of Sept. 3, the Centers for Disease Control and Prevention has received reports of 792 confirmed cases of MIS-C and 16 deaths in 42 states. Most cases are in children between ages of 1 and 14, with an average age of 8. More than 70% of reported cases have occurred in children who are Hispanic/Latino or Black.

Another ailment that parents need to be aware of is Kawasaki disease, a rare inflammatory disease that causes blood vessels to become inflamed throughout the body. The cause of Kawasaki isn’t known, but there have been more cases during the COVID-19 epidemic, sparking researchers to look for connections.

More than 80% of the children who get it are younger than 5. It can cause coronary artery dilatations and aneurysms. The hallmark of Kawasaki disease is a persistent high fever (more than 101°F) for at least four days, in addition to rash, redness to eyes, lips or tongue, swelling and redness in hands and feet, and neck swelling.

Brothers said communication plays an important role in your children’s health.

“Pediatricians are an excellent resource to discuss concerns regarding possible symptoms related to COVID-19,” he said. “The pediatricians know that we as cardiologists always are available to see the children. Based on current data, from a cardiac standpoint, I believe kids fully recover from COVID-19 infections and, when recovered, will be able to return to sports.”