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Cardiovascular post-acute sequelae of SARS-CoV-2 in children and adolescents: cohort study using electronic health records

Author

Listed:
  • Bingyu Zhang

    (University of Pennsylvania
    University of Pennsylvania)

  • Deepika Thacker

    (Nemours Children’s Health System)

  • Ting Zhou

    (University of Pennsylvania
    University of Pennsylvania Perelman School of Medicine)

  • Dazheng Zhang

    (University of Pennsylvania
    University of Pennsylvania Perelman School of Medicine)

  • Yuqing Lei

    (University of Pennsylvania
    University of Pennsylvania Perelman School of Medicine)

  • Jiajie Chen

    (University of Pennsylvania
    University of Pennsylvania Perelman School of Medicine)

  • Elizabeth A. Chrischilles

    (The University of Iowa)

  • Dimitri A. Christakis

    (Seattle Children’s Research Institute)

  • Soledad Fernandez

    (Ohio State University)

  • Vidu Garg

    (Nationwide Children’s Hospital
    The Ohio State University)

  • Susan Kim

    (University of California San Francisco)

  • Abu S. M. Mosa

    (University of Missouri School of Medicine)

  • Marion R. Sills

    (Inc
    University of Colorado School of Medicine and Children’s Hospital Colorado)

  • Bradley W. Taylor

    (Medical College of Wisconsin)

  • David A. Williams

    (University of Michigan)

  • Qiong Wu

    (University of Pennsylvania
    University of Pennsylvania Perelman School of Medicine
    University of Pittsburgh)

  • Christopher B. Forrest

    (Children’s Hospital of Philadelphia)

  • Yong Chen

    (University of Pennsylvania
    University of Pennsylvania
    University of Pennsylvania Perelman School of Medicine
    Leonard Davis Institute of Health Economics)

Abstract

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.

Suggested Citation

  • Bingyu Zhang & Deepika Thacker & Ting Zhou & Dazheng Zhang & Yuqing Lei & Jiajie Chen & Elizabeth A. Chrischilles & Dimitri A. Christakis & Soledad Fernandez & Vidu Garg & Susan Kim & Abu S. M. Mosa &, 2025. "Cardiovascular post-acute sequelae of SARS-CoV-2 in children and adolescents: cohort study using electronic health records," Nature Communications, Nature, vol. 16(1), pages 1-12, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-56284-0
    DOI: 10.1038/s41467-025-56284-0
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    References listed on IDEAS

    as
    1. Ziyad Al-Aly & Yan Xie & Benjamin Bowe, 2021. "High-dimensional characterization of post-acute sequelae of COVID-19," Nature, Nature, vol. 594(7862), pages 259-264, June.
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