Key result
Post-pandemic rebound in acute rheumatic fever cases shows no significant change in carditis rates.
Why the study?
Acute rheumatic fever remains a significant cause of acquired heart disease in children in developing countries, with unclear post-pandemic trends and clinical characteristics.
Does the post-pandemic period alter the presentation and frequency of acute rheumatic fever in children compared to the pandemic period?
Cohort (n=122)
No
Does the post-pandemic period alter the presentation and frequency of acute rheumatic fever in children compared to the pandemic period?
Absolute Event Rate: 96% vs 92%
p-value: p=0.403
There was an increase in the monthly presentation of acute rheumatic fever post-pandemic likely due to referral dynamics, with severe cardiac involvement strongly associated with delayed presentation and elevated inflammatory markers.
Post-pandemic ARF rise warrants surveillance without practice change; leaves open true incidence shifts versus referral effects.
Objectives: Acute rheumatic fever (ARF) remains a significant cause of acquired heart disease among children in developing countries. This study aimed to evaluate the clinical, laboratory, and echocardiographic characteristics; treatment approaches; and outcomes of ARF patients followed in a tertiary pediatric cardiology center and to explore differences between pandemic and post-pandemic periods. Materials and Methods: In this retrospective study, 122 patients diagnosed with ARF between May 2020 and August 2025 were analyzed. Using June 2022—when pandemic restrictions were eased—as a reference point, patients were divided into two groups: pandemic (n=41) and post-pandemic (n=81). Demographic characteristics, clinical findings, laboratory results, echocardiographic findings, treatments, and follow-up data were compared. Results: The mean age was 12.8±2.4 years, and 62.3% of patients were male. The monthly number of cases increased from 1.58 to 2.13 in the post-pandemic period (p=0.048). Carditis was detected in 95% of patients, consistent with the tertiary referral profile of our study population. Although the rate of carditis was numerically higher in the post-pandemic period, the difference was not statistically significant (92% vs. 96%, p=0.403). Delayed presentation and elevated C-reactive protein levels were associated with carditis. Conclusion: An apparent increase in ARF cases was observed in the post-pandemic period; however, this likely reflects referral dynamics rather than a true epidemiological shift. Delayed presentation and increased inflammatory burden were associated with more severe cardiac involvement.
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Genç et al. (2026) conducted a cohort in Acute rheumatic fever (ARF) (n=122). Post-pandemic period vs. Pandemic period was evaluated on Carditis (p=0.403). The post-pandemic period saw an increase in monthly acute rheumatic fever cases (2.13 vs 1.58, P=0.048), but no significant difference in carditis rates compared to the pandemic (96% vs 92%, P=0.403).
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