10-year-old patient with fulminant myocarditis due to Covid-19

April 25, 2022 12:32 GMT+7

According to information from Dr. Dr. Phan Huu Phuc – Deputy Director of the Children’s Covid-19 Intensive Care Center, National Children’s Hospital, on March 16, the hospital received a case of 10-year-old MQ child (Quang Ninh). , was hospitalized with a state of cardiogenic shock, fulminant myocarditis due to Covid-19.

NTN (the baby’s mother): 4 days before being admitted to the hospital, the child had a high fever of 39 degrees, the family quickly tested positive for SARS-CoV-2. However, because of the subjective psychology, thinking that it was only a mild fever and quickly recovered, so the family did not take the child to the doctor.

When the child was tired, had difficulty breathing, was pale and his family took him to the hospital, the doctors informed him that he was in critical condition.

This is one of the most critical patients at the Children’s Covid-19 Intensive Care Center, National Children’s Hospital.

Dr. Dr. Dao Huu Nam – Head of the Department of Intensive Care, Center for Intensive Care of Children with Covid-19 Patients, National Children’s Hospital recounted: “The child was admitted to the hospital with a high fever and fatigue, and difficulty breathing. , respiratory-circulatory failure. It is known that the child’s history is normal and healthy, with no underlying diseases or special symptoms.”

This patient has a different course and characteristics compared to other cases, which is a challenge for doctors in diagnosis and treatment.

Dr Phuc said: “At that time, we thought of the situations, because he had a previous episode of SARS-CoV-2 infection, so the shock, severe myocardial damage could be in the context of inflammatory syndrome. multisystem (MIS-C), but can also be caused by another episode of acute viral infection.

Therefore, along with the initial resuscitation measures such as supporting the child’s vital functions, we must explore more tests to determine the exact cause of diagnosis and have appropriate treatment solutions.”

This patient is the first Covid-19 patient to undergo dialysis and ECMO at the National Children’s Hospital

Facing the urgent situation, the doctors of the National Children’s Hospital have coordinated many measures such as mechanical ventilation and dialysis with an adsorbent filter. In addition to helping to regulate homeostasis and epidemic control, this measure helps eliminate inflammatory mediators (such as cytokines) in the case of severe illnesses caused by Covid-19. , thereby helping the patient’s overall condition to improve more easily.

After the patient received initial resuscitation treatment in the above direction, in the first 1-2 days, the patient was quite stable and the prognosis was better, but then the patient suddenly got worse, the doctors decided to Children are scheduled to run ECMO in the hope of saving the baby’s life. This is a complex technique in the resuscitation treatment of critically ill patients with Covid-19, which is considered the last resort to save a child’s life.

Combining all the treatment measures, going through many stressful days, the patient finally passed the critical stage, crossed the fragile line of life.

According to information from Dr. Dr. Dao Huu Nam, the total number of days the child had dialysis was 5 days, mechanical ventilation for 15 days and ECMO 8 days, after that dangerous period, the patient was weaned from ECMO and trained to breathe normally again.

Dr. Dao Huu Nam said: “Up to now, the total number of patients at the Children’s Intensive Care Center for COVID-19 patients is about more than 500 patients, although this is one of the most severe patients requiring a combination of measures. The complex treatment, the success of saving the baby’s life when his life is very fragile makes us very happy.”

After a period of treatment and resuscitation, the doctors assessed that the patient’s condition was quite stable, the recovery ability was relatively good, and the heart function had clearly improved. The condition gradually stabilized back to normal. Currently, the baby is being prepared for discharge from the hospital and continues to be periodically re-examined by a cardiologist.

Most children with Covid-19 have mild symptoms and recover quickly. However, the above pediatric case may be in serious danger because of acute myocarditis, so doctors recommend that the community should not be subjective with Covid-19, especially young children and adolescents. .

According to statistics from the US CDC from data from more than 900 hospitals, Covid-19 is the leading culprit for myocarditis in children under 16 years of age. The rate of myocarditis in infected children is 0.133%, the risk of myocarditis in children with Covid-19 is 37 times higher than in the group without Covid-19.

So. When detecting that their child has symptoms such as high fever, chest pain, palpitations, cyanosis, shortness of breath, fatigue, lethargy, heart palpitations, etc., parents need to take the child to the nearest medical facility for treatment. timely detection and treatment.

In addition, parents should pay attention to the vaccination against Covid-19 for children of vaccination age according to regulations of the Ministry of Health. Because, the work of vaccination against Covid-19 is very important, contributing to protecting the health of children in the context of the Covid-19 pandemic still having many complicated developments.

K.Chi