Int J Clin Pediatr

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. 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. Electrocardiogram (EKG): 140 bpm, ventricular extrasystoles, minimal ST-segment elevation and T-wave inversion in lead V1. QT-c normal.

Figure 3. Chest X-ray: normal. It was repeated twice, and no signs suggested pneumonia.

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. 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 0	Day 1	Day 2	Day 3	Day 4	Day 5	Day 6
PCR: polymerase chain reaction; PCT: procalcitonin; LDH: lactate dehydrogenase; IL-6: interleukin 6; Pro-BNP: pro b-type natriuretic peptide.
PCR (mg/dL)	13.8	15.17	17.79	12.57	4.74	1.64	0.6
PCT (ng/mL)	0.76	2.01	2.07	1.43	0.74	0.36	0.12
Hemoglobin (g/dL)	14.4	12.8	11.7	11	11	11.4	12
Platelets (10⁹/L)	153	193	228	228	264	285	378
Leukocytes (10⁹/L)	5.5	12.1	12.3	9.4	8.6	7.8	13.5
Neutrophils (10⁹/L)	4.86	11.36	11.57	8.89	7.91	5.98	10.70
Lymphocytes (10⁹/L)	390	400	500	410	550	840	1,600
D-dimer (ng/mL)	1,810	2,070	2,200	1,130	850	820	270
Fibrinogen (mg/dL)	473	535	528	574	522	470	373
LDH (U/L)	310	228	214	210	236	255	285
IL-6 (pg/mL)	558	140	60.3	303.9	50.8	15.9	7.5
Troponin (ng/L)	112.7	69.8	37.2	26.1	21.6	19.3	14.36
Pro-BNP (pg/mL)	4,051	4,490	1,832	922	432	324	58
Ferritin (ng/mL)	329.6	304.7	323.6	291.4	N/A	N/A	N/A