BRIEF RESEARCH REPORT article
Front. Cardiovasc. Med.
Sec. Pediatric Cardiology
Cardiovascular phenotyping of children and adolescents with Post-COVID syndrome (PCS) at initial diagnosis - A prospective observational single-center study
Provisionally accepted
Hosan Hasan1Dagmar Hohmann1Klea Hysko1Sarah Ibahrine1Valeria Skeries2Katharina Dold2Gesa Hellen Pöhler3Diane Renz3Martin Wetzke2
Georg Hansmann4*- 1Department of Pediatric Cardiology and Critical Care, Hannover Medical School, Hannover, Germany, Hannover, Germany
- 2Department of Pediatric Pulmonology, Allergology and Neonatology, Hannover Medical School, Hannover, Germany, Hannover, Germany
- 3Department of Diagnostic and Interventional Radiology, Hannover Medical School, Hannover, Germany, Hannover, Germany
- 4Department of Pediatric Cardiology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany, Erlangen, Germany
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The aim of this study was to conduct deep cardiovascular phenotyping in pediatric patients with Post-COVID Syndrome (PCS) at initial presentation using cardiac MRI (CMR), echocardiography and electrocardiogram. Prospective, single center cohort study. PCS was defined as follows: persistent symptoms such as reduced physical performance, poor concentration, mood symptoms, headaches, sleep disorders and dysosmia, for at least 12 weeks after PCR-confirmed SARS-CoV-2 infection. A total of 100 pediatric patients (age 7-18 years) and 20 age/gender matched healthy controls (age 8-18 years) were enrolled. Data collection consisted of 12-lead electrocardiogram, echocardiography, including biventricular strain analysis. 42 of the 100 PCS patients (age 9-18 years) and 28 age/gender matched healthy controls (age 8-18 years) received CMR cine mass/volumes quantification in short axis and tissue tracking analysis of the RV and LV. Laboratory studies included serum NTproBNP and Troponin c. CMR-derived RV global radial strain (22.6±1.00 vs 27.1±1.13%; p=0.003), and RV global circumferential strain (-13.5±0.55 vs. -15.2±0.51%; p=0.045) were significantly decreased in PCS vs. CON. Children with PCS also tended to have mildly reduced RVEF (50.9±0.80 vs. 53.5±0.66%; p=0.259). RV mass index was increased in PCS compared to CON (19.06±0.47 vs. 16.4±0.53g/m²; p=0.0002), though in normal range referred to age-appropriate normal values. PCS is associated with decreased CMR-based radial and circumferential RV contractility and slightly increased RV mass in children with PCS compared to healthy, age/gender matched controls. In contrast, LV contractility (strain) and mass were not affected.
Keywords: Cardiac MRI, Echocardiogaphy, pediatric cardiology, post-COVID syndrome, Strain analysis
Received: 14 Jul 2025; Accepted: 02 Feb 2026.
Copyright: © 2026 Hasan, Hohmann, Hysko, Ibahrine, Skeries, Dold, Pöhler, Renz, Wetzke and Hansmann. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Georg Hansmann
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