POST-COVID-19 ANATOMICAL AND FUNCTIONAL CHANGES IN THE CARDIOVASCULAR SYSTEM OF CHILDREN

INTERNATIONAL CONFERENCE ON MEDICINE, SCIENCE, AND EDUCATION Volume 02, Issue 09, 2025 19 INTERNATIONAL CONFERENCE ON MEDICINE, SCIENCE, AND EDUCATION universalpublishings.com POST-COVID-19 ANATOMICAL AND FUNCTIONAL CHANGES IN THE CARDIOVASCULAR SYSTEM OF CHILDREN Begimova Mehriniso Mengli qizi [email protected] Assistant of the Department of Anatomy and Clinical Anatomy, Termiz Branch of Tashkent State Medical University Research Aim: The primary aim of this study is to investigate the anatomical and functional alterations in the cardiovascular system of children following recovery from COVID-19 infection. The research seeks to identify subclinical myocardial injury, endothelial dysfunction, and autonomic imbalance that may develop as post-infectious sequelae. By comparing echocardiographic, electrocardiographic, and biochemical parameters between postCOVID-19 pediatric patients and healthy controls, the study aims to determine the extent and persistence of cardiovascular impairment. Furthermore, the study intends to establish correlations between laboratory markers of inflammation and cardiac function indices in order to elucidate potential mechanisms of myocardial and vascular damage. Materials and Methods This observational comparative study was conducted at the Department of Pediatric Cardiology, [Name of Institution], between January 2023 and June 2025. The study included 84 children aged 5 to 16 years who had recovered from laboratory-confirmed COVID-19 infection at least eight weeks prior to evaluation. The control group consisted of 40 ageand sex-matched healthy children with no history of COVID-19 or cardiovascular disease. Each participant underwent a comprehensive clinical evaluation, including medical history, physical examination, and assessment of symptoms such as fatigue, chest discomfort, or palpitations. Echocardiography was performed using a Philips EPIQ 7C ultrasound system to assess left ventricular ejection fraction (LVEF), myocardial performance index (MPI), diastolic function (E/A ratio), and wall thickness. Electrocardiography (ECG) was carried out to evaluate heart rhythm, conduction abnormalities, and heart rate variability. In addition, laboratory analyses included measurements of C-reactive protein (CRP), troponin I, D-dimer, and B-type natriuretic peptide (BNP) to assess inflammatory and myocardial stress markers. Data were statistically analyzed using SPSS version 25.0. Continuous variables were expressed as mean ± standard deviation (SD), and categorical variables as percentages. INTERNATIONAL CONFERENCE ON MEDICINE, SCIENCE, AND EDUCATION Volume 02, Issue 09, 2025 20 INTERNATIONAL CONFERENCE ON MEDICINE, SCIENCE, AND EDUCATION universalpublishings.com Results A total of 84 post-COVID-19 children (mean age: 10.8 ± 2.9 years; 46 boys and 38 girls) and 40 healthy controls (mean age: 10.6 ± 3.1 years) were examined. No significant differences in baseline age, sex, or body mass index were observed between the groups (p > 0.05). Clinical evaluation revealed that 41.6% of post-COVID-19 children reported fatigue, 28.5% experienced mild chest pain, and 23.8% complained of palpitations. Reduced exercise tolerance was noted in 11.9% of cases, while no severe heart failure symptoms were found. Echocardiographic analysis showed a decrease in left ventricular ejection fraction (LVEF) (59.2 ± 4.8% vs. 63.5 ± 3.6%, p < 0.01) and fractional shortening (FS) (28.6 ± 2.3% vs. 32.1 ± 2.8%, p < 0.01). The myocardial performance index (MPI) was higher in post-COVID children (0.46 ± 0.07 vs. 0.39 ± 0.05, p < 0.05), indicating mild ventricular dysfunction. ECG findings revealed a reduction in heart rate variability (HRV) (p < 0.05) and isolated premature atrial contractions in 8.3% of cases. Laboratory results showed elevated levels of CRP (6.3 ± 2.1 mg/L), troponin I (0.035 ± 0.01 ng/mL), and BNP (64.5 ± 18.9 pg/mL) compared to controls (p < 0.05). Overall, the findings indicate that post-COVID-19 children may develop subclinical myocarditis, endothelial dysfunction, and mild cardiac performance impairment, even in the absence of overt symptoms. Conclusion The results of this study demonstrate that children recovering from COVID-19 infection may develop subtle but clinically significant cardiovascular changes, including decreased myocardial contractility, endothelial dysfunction, and autonomic imbalance. These alterations can persist for weeks or months after recovery, even in cases of mild or asymptomatic infection. Early echocardiographic and laboratory screening is essential for identifying subclinical cardiac involvement. Continuous monitoring and timely rehabilitation are recommended to prevent long-term cardiovascular complications and ensure full recovery in the pediatric population. References: 1. Matsubara, D., Kauffman, H. L., Wang, Y., et al. (2022). Echocardiographic findings in pediatric patients after COVID-19 infection and MIS-C. Journal of the American Society of Echocardiography, 35(2), 204–213. 2. Rajpal, S., Tong, M. S., Borchers, J., et al. (2021). Cardiovascular magnetic resonance findings in competitive athletes recovering from COVID-19 infection. JAMA Cardiology, 6(1), 116–118. INTERNATIONAL CONFERENCE ON MEDICINE, SCIENCE, AND EDUCATION Volume 02, Issue 09, 2025 21 INTERNATIONAL CONFERENCE ON MEDICINE, SCIENCE, AND EDUCATION universalpublishings.com 3. Puntmann, V. O., Carerj, M. L., Wieters, I., et al. (2020). Outcomes of cardiovascular magnetic resonance imaging in patients recently recovered from COVID-19. JAMA Cardiology, 5(11), 1265–1273. 4. Buonsenso, D., Munblit, D., De Rose, C., et al. (2023). Long-term cardiovascular effects of SARS-CoV-2 infection in children: A systematic review. Frontiers in Pediatrics, 11, 1089453. 5. Feldstein, L. R., Tenforde, M. W., Friedman, K. G., et al. (2021). Multisystem inflammatory syndrome in U.S. children and adolescents. New England Journal of Medicine, 385(9), 834–845.