Vukomanovic, Vladislav A. (55881072000)Vladislav A. (55881072000)VukomanovicKrasic, Stasa (57192096021)Stasa (57192096021)KrasicPrijic, Sergej (20734985500)Sergej (20734985500)PrijicNinic, Sanja (51864038300)Sanja (51864038300)NinicMinic, Predrag (6603400160)Predrag (6603400160)MinicPetrovic, Gordana (57211071996)Gordana (57211071996)PetrovicNesic, Dejan (26023585700)Dejan (26023585700)Nesic2025-06-122025-06-122021https://doi.org/10.1097/INF.0000000000003094https://www.scopus.com/inward/record.uri?eid=2-s2.0-85104338547&doi=10.1097%2fINF.0000000000003094&partnerID=40&md5=ed527f2fd3bebf74debcfc2f135f8d99https://remedy.med.bg.ac.rs/handle/123456789/4221Background: Acute myocarditis (AM) is defined as inflammation of the myocardium. The aim of our study is a comparative analysis of the differences between AM related and unrelated to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: The retrospective study included children with AM treated from January 2018 to November 2020. Results: The study included 24 patients; 7 of 24 had AM related to SARS-CoV-2 and they were older than 7. They were more likely to have abdominal pain (P = 0.014), headache (P = 0.003), cutaneous rash (P = 0.003), and conjunctivitis (P = 0.003), while fulminant myocarditis was commonly registered in AM unrelated to SARS-CoV-2 (P = 0.04). A multisystem inflammatory syndrome in children associated with COVID-19 was diagnosed in six adolescents. Patients with AM related SARS-CoV-2 had lower serum cardiac troponin I (cTnI) (P = 0.012), and platelets (P < 0.001), but had a higher C-reactive protein (CRP) value (P = 0.04), and N-terminal-pro hormone BNP in comparison to patients with AM unrelated to SARS-CoV-2. The patients with AM related to SARS-CoV-2 had significant reduction of CRP (P = 0.007). Inotropic drug support was used for shorter durations in patients with AM related to SARS-CoV-2, than in others (P = 0.02). Children with AM related to SARS-CoV-2 had significant improvement of left ventricle systolic function on the third day in hospital (P = 0.001). Patients with AM unrelated to SARS-CoV-2 AM had more frequent adverse outcomes (P = 0.04; three died and four dilated cardiomyopathy). Conclusions: In contrast to patients with AM unrelated to SARS-CoV-2, patients with AM related to SARS-CoV-2 had a higher CRP value, polymorphic clinical presentation, shorter durations of inotropic drugs use as well as prompt recovery of left ventricle systolic function. © 2021 Lippincott Williams and Wilkins. All rights reserved.acute myocarditismultisystem inflammatory syndrome in childrenpediatricsevere acute respiratory syndrome coronavirus 2