International Journal of Clinical Pediatrics, ISSN 1927-1255 print, 1927-1263 online, Open Access
Article copyright, the authors; Journal compilation copyright, Int J Clin Pediatr and Elmer Press Inc
Journal website http://www.theijcp.org

Case Report

Volume 9, Number 3, September 2020, pages 92-97


Severe Cardiac and Abdominal Manifestations Without Lung Involvement in a Child With COVID-19

Figures

Figure 1.
Figure 1. Erythematous annular lesions on palms and soles. They were not reported to itch or cause any pain, and they resolved without peeling or changes in skin pigmentation.
Figure 2.
Figure 2. Electrocardiogram (EKG): 140 bpm, ventricular extrasystoles, minimal ST-segment elevation and T-wave inversion in lead V1. QT-c normal.
Figure 3.
Figure 3. Chest X-ray: normal. It was repeated twice, and no signs suggested pneumonia.
Figure 4.
Figure 4. Cardiac MRI: generalized myocardial edema, T1 hyperintensity in the septal area and mild pericardial effusion. No late gadolinium enhancement was noted. MRI: magnetic resonance imaging.
Figure 5.
Figure 5. Abdominal CT: hepatosplenomegaly, nonspecific thickening of the terminal ileum (arrow) and segmental thickening of the ascending colon and transverse colon (arrows). CT: computed tomography.

Table

Table 1. Progression of Laboratory Test Values
 
Day 0Day 1Day 2Day 3Day 4Day 5Day 6
PCR: polymerase chain reaction; PCT: procalcitonin; LDH: lactate dehydrogenase; IL-6: interleukin 6; Pro-BNP: pro b-type natriuretic peptide.
PCR (mg/dL)13.815.1717.7912.574.741.640.6
PCT (ng/mL)0.762.012.071.430.740.360.12
Hemoglobin (g/dL)14.412.811.7111111.412
Platelets (109/L)153193228228264285378
Leukocytes (109/L)5.512.112.39.48.67.813.5
Neutrophils (109/L)4.8611.3611.578.897.915.9810.70
Lymphocytes (109/L)3904005004105508401,600
D-dimer (ng/mL)1,8102,0702,2001,130850820270
Fibrinogen (mg/dL)473535528574522470373
LDH (U/L)310228214210236255285
IL-6 (pg/mL)55814060.3303.950.815.97.5
Troponin (ng/L)112.769.837.226.121.619.314.36
Pro-BNP (pg/mL)4,0514,4901,83292243232458
Ferritin (ng/mL)329.6304.7323.6291.4N/AN/AN/A