Unmasking Heart Threats Lurking in Children After COVID-19 Infection

Researchers from Harvard University and the Australian National Phenome Centre at Murdoch University analyzed blood samples from 147 children with varying COVID-19 conditions. The research demonstrated that children infected with COVID-19 may face a higher risk of cardiovascular disease, as indicated by changes in blood plasma metabolites.They found significant metabolic disruptions that persist beyond the acute phase of infection, affecting the body’s ability to process fats such as triglycerides and cholesterol, which are essential for maintaining heart health.

Metabolic Profiling of 147 Children Reveals That Even Mild COVID-19 Cases Can Cause Persistent Disruptions

While most children infected with SARS-CoV-2 show mild symptoms, a small number can develop serious complications either during the initial illness or weeks later. These delayed effects, known as post-acute sequelae of COVID-19 (PASC), include conditions such as Multisystem Inflammatory Syndrome in Children (MIS-C) and long COVID. MIS-C is a rare but severe inflammatory condition with symptoms like fever, gut issues, heart problems, and shock. Long COVID, which is more common, affects around 6% of those infected and can lead to chronic fatigue, heart-related symptoms, and other lingering health problems.

Researchers found that some children continued to experience health problems long after recovering from COVID-19. Evidence pointed to lingering viral particles in the gut, weakened intestinal barriers, and inflammatory responses that caused damage to blood vessels and the heart. While cases of MIS-C became less common, long COVID remained a concern, with an estimated 6% of children and adults affected. Many of these individuals reported cardiovascular symptoms such as chest pain, reduced exercise tolerance, and abnormal heart rate regulation.

To better understand the long-term impact of COVID-19 in children, scientists analyzed blood samples from 147 children using metabolic profiling; the largest study of its kind to date. This method revealed lasting changes in how the body processed fats and other key molecules related to heart function. The findings confirmed that COVID-19 led to persistent metabolic disruptions, which could raise the risk of future cardiovascular problems in children.

“A minority of children experience a more severe immunologically driven form of the disease (MIS-C) that is associated with longer term GI effects and cardiovascular disease,” said lead researcher Professor Jeremy Nicholson, Director of The Australian National Phenome Centre.

Advanced Blood Analyses Reveal That Children With MIS-C Exhibit Altered Fat Metabolism Marked by Elevated VLDL

Using a combination of advanced blood testing methods, researchers identified key differences in how children’s bodies respond to COVID-19 and MIS-C. They found that although both conditions triggered inflammation, children with MIS-C showed distinct patterns of fat metabolism, specifically elevated levels of triglycerides and very-low-density lipoprotein (VLDL) particles. These changes were not due to differences in the types of fats carried in the blood, but rather the sheer number of circulating VLDL particles. This suggests the liver may increase fat production during MIS-C, and that children with the condition struggle to clear these fats due to reduced activity of an enzyme called lipoprotein lipase, which helps break down triglycerides.

Further analysis showed that this imbalance also affected cholesterol transport. Researchers found that high-density lipoprotein (HDL), which normally removes cholesterol from the blood, carries more triglycerides and less cholesterol ester, reducing its efficiency. Inflammation likely caused these changes by reducing the number and altering the composition of HDL particles. These disruptions in lipid metabolism, especially in children with MIS-C, could reduce the body’s ability to regulate fats and clear harmful particles, increasing long-term cardiovascular risk.

The study also revealed a link between weight and these metabolic changes. A significant number of children with MIS-C and COVID-19 were overweight or obese, with up to 55% of COVID-19 cases falling into this category. This excess weight is known to increase the presence of harmful cholesterol particles and compounds the metabolic effects observed. The findings suggest that obesity may worsen inflammatory responses and metabolic disturbances following SARS-CoV-2 infection, highlighting the need for closer monitoring and tailored strategies to reduce long-term health risks in children recovering from COVID-19 and MIS-C.

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Denisse Sandoval