ABSTRACT
Objective: To evaluate both short and mid-term effects of
maternal COVID-19 on cardiac functions of fetuses and children.
Methods: The present case-control study was conducted on 36
pregnant women who had COVID-19 infection in the second trimester of
pregnancy and 30 pregnant women as healthy controls. Fetal, neonatal and
infant cardiac functions were compared between the groups. Assessment of
fetal cardiac functions were performed in the last trimester of the
pregnancy at least 6 weeks after the recovery of infection. The first
postnatal echo was performed within the first two weeks and the
follow-up (second) echo was performed in the 6-8 weeks of life.
Results: The demografic data were similar between groups.
Interventricular septum and left ventricular posterior wall
end-diastolic dimensions were significantly higher in the study group in
both fetal, neonatal and infant periods. Impaired diastolic functions of
right and left ventricles were detected and myocardial performance
indexes with tissue doppler imaging of both lateral walls and septum
were significantly higher than controls at all periods.
Conclusion: Maternal COVID-19 seems to have a global impact on
cardiac functions of babies in the short and mid-term periods after
maternal recovery.
KEY WORDS: maternal COVID-19, cardiac function, miyocardial
performance index, fetal, infant, echocardiography.
INTRODUCTION :
Pregnant women with COVID-19 are at greater risk for pregnancy
complications like preterm delivery and fetal distress. Their newborns
are more likely to be admitted to the neonatal ICU [1,4]. SARS-CoV-2
related excessive inflammation, coagulation disorders and hypoxemia may
cause placental insufficiency leading to adverse perinatal outcomes and
fetal mortality [5].
COVID-19 infection in neonates and children showed mild symptoms and
better outcomes compared to adults. But cardiovascular involvement of
the SARS-CoV-2 virus and multisystem inflammatory syndrome in neonates
and children (MIS-N, MIS-C) seems to be crucial and life-threatening
[6,7]. Although, there are some studies in the literature evaluating
the effect of COVID-19 on fetal and neonatal cardiac functions, the
evidence of long-term cardiovascular outcome of COVID-19 infection
and/or MIS-N is scant [8,9]. We aimed to investigate the short and
mid-term influence of maternal mild to moderate COVID-19 infection on
cardiac functions of fetus, neonate and infant.