The impact of COVID-19 on the practice of pediatric cardiology: a narrative review

Background and Objective: Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome virus 2 (SARS-CoV-2), is a global pandemic evolving in real time and affecting persons of all ages. Contemporary pediatric data demonstrate that children of all ages are susceptible to SARSCoV-2, and that infants under 1 year of age are at risk for severe disease although this still is a relatively rare outcome. This narrative overview discusses the impact of the COVID-19 pandemic on various aspects of pediatric cardiology, and proposes strategies to mitigate disruptions, so as to better future -proof our practice. Methods: PubMed, EMBASE and Google Scholar databases were searched for literature in English from year 2020 through April 2021. Key Content and Findings: There is an overall decreased in ambulatory clinic volume with clinical visits restricted for emergency purposes. Cardiovascular services including transthoracic echocardiography, fetal echocardiography, cardiac catheterization and intervention, and cardiac surgeries have been reported to have declined and performed on a priority basis. Infants and young children with hemodynamically significant congenital heart disease, cyanosis and pulmonary hypertension may constitute a vulnerable group with known susceptibility to acute infectious viral illnesses, and could be considered high -risk for complications related to COVID-19 infection. Associated with SARS-CoV-2, the newly described multisystem inflammatory syndrome in children have led to serious and life -threatening illness in previously healthy children and adolescents. Conclusions : COVID-19 has had a profound impact on the practice of pediatric cardiology and will continue to affect all aspects of patient care. As pediatric cardiologists play an important role in the care and outcomes of these patients, the approach to the evaluation and management of children with heart disease in the COVID-19 era, will evolve as the pandemic rages on. Strategies incorporating new technologyenabled options, maintaining staff well-being, both physically and mentally, and ensuring adequate supply of consumables including personal protective equipment (PPE) and machines are imperative for us to fight the challenge.