Coronavirus disease 2019 (COVID-19) has a predilection to cardiac involvement. The early clinical phase, during viremia, may manifest as pericarditis, acute myocarditis, and sepsis-related cardiomyopathy. Delayed presentations, such as multisystem inflammatory syndrome in children, coronary artery dilation/aneurysms, and late myocarditis, may occur in the weeks after the acute infection. These delayed presentations commonly test negative for severe acute respiratory syndrome coronavirus 2 via polymerase chain reaction testing and are thought to be primarily postviral hyperinflammatory sequelae. The long-term consequences of cardiac involvement in COVID-19 are unknown. Most recommendations for cardiac management are based on known conditions that are similar. For example, coronary aneurysms can be managed under Kawasaki disease guidelines. Similarly, for patients with COVID-19 myocarditis, they can be cleared for sports under protocols for other types of myocarditis. There is concern for cardiac involvement as a subclinical entity even in more minor presentations. Several expert algorithms have been developed for clearing competition athletes to return to exercise. Sports clearance should be individualized considering the severity of disease, age of patient, and performance level of the sport. [Pediatr Ann. 2021;50(3):e128-e135.].

中文翻译：

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COVID-19 在儿童和年轻人中的心脏后遗症。

2019 年冠状病毒病 (COVID-19) 好发于心脏受累。病毒血症期间的早期临床阶段可能表现为心包炎、急性心肌炎和败血症相关的心肌病。急性感染后数周内可能会出现延迟表现，例如儿童多系统炎症综合征、冠状动脉扩张/动脉瘤和晚期心肌炎。这些延迟表现通常通过聚合酶链反应检测对严重急性呼吸系统综合症冠状病毒 2 呈阴性，并被认为主要是病毒后高炎症后遗症。COVID-19 心脏受累的长期后果尚不清楚。大多数关于心脏管理的建议都是基于相似的已知条件。例如，冠状动脉瘤可以根据川崎病指南进行管理。同样，对于 COVID-19 心肌炎患者，他们可以根据其他类型心肌炎的协议进行运动。即使在更轻微的表现中，也有人担心心脏受累是一个亚临床实体。已经开发了几种专家算法来清除比赛运动员恢复锻炼。考虑到疾病的严重程度、患者的年龄和运动的表现水平，运动清除应个体化。[小儿安。2021;50(3):e128-e135.]。考虑到疾病的严重程度、患者的年龄和运动的表现水平，运动清除应个体化。[小儿安。2021;50(3):e128-e135.]。考虑到疾病的严重程度、患者的年龄和运动的表现水平，运动清除应个体化。[小儿安。2021;50(3):e128-e135.]。