A couple weeks ago, I explained my hesitance to accept the  more-extreme declarations of Andrew Bostom, particularly that there have been no COVID deaths among children.  Two updates are worth making.

I’ve clarified directly with the state Department of Health that one of the three deaths among Rhode Island children who tested positive for the coronavirus is still of an undetermined cause.  Thus, while doctors have ruled COVID out as a contributing cause for two of the patients, it could not do so for the third.  The fact that COVID has not been confirmed to be a contributing cause is not the same as a finding that it was not.  Therefore, we cannot say that there have been zero pediatric deaths caused by COVID; we can only say that we don’t know.

Bostom waves this straightforward analysis away by insisting that only deaths involving pneumonia should count.  A new study posted to the National Library of Medicine confirms my suggestion that his assumption is premature:

Forty-one (41) patients admitted to Rhode Island hospitals with COVID-19 from April to November 2020 were identified to have severe cardiac complications. Clinical presentations of cardiovascular system toxicity in COVID-19 included myocarditis, pericarditis, cardiomyopathy, ACS and cardiac arrhythmia. Clinical features, hospital outcomes and post-discharge outcomes were characterized. Acute myocarditis (46.3%) and cardiomyopathy (29.3%) were the most common findings followed by cardiac arrhythmia, acute coronary syndrome, and pericardial disease. Pulmonary involvement of COVID-19 was absent in 41.5% of patients. Comorbid cardiovascular conditions were absent in 29.3% of patients. Severe cardiac complications in COVID-19 were associated with an in-hospital mortality rate of 61%. Among survivors with COVID-19-related cardiomyopathy, only 20% demonstrated recovery of LV function on follow-up echocardiography done within 12 weeks after initial diagnosis. Identification, diagnosis and management of severe cardiac complications in COVID-19 are discussed.

I don’t have access to the full study, so I can’t say how much overlap there are among the percentages cited in the abstract, but the significant points are that:

• 42% of the patients with COVID-related heart complications had no pulmonary effects.
• 29% had no prior cardiovascular conditions.
• 61% of those with severe cardiac complications died.

In short, pneumonia does not have to be present for somebody to die from COVID.

This finding is also important to keep in mind while comparing the risks of the vaccine with the risk of the virus.

Featured image by the CDC.