ABSTRACT
SARS-CoV-2 infection has been associated with cardiovascular disease in children, but which children need cardiac evaluation is unclear. We describe our experience evaluating 206 children for cardiac disease following SARS-CoV-2 infection (one of whom had ventricular ectopy) and propose a new guideline for management of these children. Routine cardiac screening after SARS-CoV-2 infection in children without any cardiac signs or symptoms does not appear to be high yield.
Subject(s)
Aftercare , COVID-19/physiopathology , Heart Diseases/diagnosis , Referral and Consultation , Adolescent , Ambulatory Care , Atrioventricular Block/diagnosis , Atrioventricular Block/etiology , Atrioventricular Block/physiopathology , Bradycardia/diagnosis , Bradycardia/etiology , Bradycardia/physiopathology , COVID-19/complications , Cardiology , Chest Pain/physiopathology , Child , Child, Preschool , Dyspnea/physiopathology , Echocardiography , Electrocardiography , Fatigue/physiopathology , Female , Heart Diseases/etiology , Heart Diseases/physiopathology , Humans , Hypertrophy, Left Ventricular/diagnosis , Hypertrophy, Left Ventricular/etiology , Hypertrophy, Left Ventricular/physiopathology , Hypertrophy, Right Ventricular/diagnosis , Hypertrophy, Right Ventricular/etiology , Hypertrophy, Right Ventricular/physiopathology , Implementation Science , Male , Pediatrics , Practice Guidelines as Topic , SARS-CoV-2 , Severity of Illness Index , Syncope/physiopathology , Ventricular Premature Complexes/diagnosis , Ventricular Premature Complexes/etiology , Ventricular Premature Complexes/physiopathology , Young AdultSubject(s)
Atrioventricular Block/etiology , Bundle of His/physiopathology , COVID-19/complications , Cardiac Pacing, Artificial/methods , Electrocardiography , Atrioventricular Block/physiopathology , Atrioventricular Block/therapy , COVID-19/epidemiology , Female , Humans , Middle Aged , Pandemics , SARS-CoV-2ABSTRACT
AIMS: The novel coronavirus SARS-CoV-2 has shown the potential to significantly affect the cardiovascular system. Cardiac arrhythmias are commonly reported complications in COVID-19 hospitalized patients. METHODS AND RESULTS: While tachyarrhythmias seem most common, we describe four cases of COVID-19 patients who developed a transient high-degree atrioventricular (AV) block during the course of their hospitalization. All four patients who developed a high-degree AV block during their hospitalization with COVID-19 did not require permanent pacing. CONCLUSION: Similarly to most AV blocks associated with infectious organisms and given its transient nature, this case series suggests that conservative management strategies should be preferred in COVID-19 patients who develop complete heart block.
Subject(s)
Atrioventricular Block/etiology , Atrioventricular Node/physiopathology , COVID-19/complications , Heart Rate , Hospitalization , Action Potentials , Adult , Atrioventricular Block/diagnosis , Atrioventricular Block/physiopathology , Atrioventricular Block/therapy , COVID-19/diagnosis , COVID-19/therapy , Conservative Treatment , Electrocardiography , Female , Humans , Male , Middle Aged , Risk Factors , Treatment OutcomeABSTRACT
OBJECTIVES: Multisystem inflammatory syndrome in children (MIS-C) has spread through the pediatric population during the coronavirus disease 2019 pandemic. Our objective for the study was to report the prevalence of conduction anomalies in MIS-C and identify predictive factors for the conduction abnormalities. METHODS: We performed a single-center retrospective cohort study of pediatric patients <21 years of age presenting with MIS-C over a 1-month period. We collected clinical outcomes, laboratory findings, and diagnostic studies, including serial electrocardiograms, in all patients with MIS-C to identify those with first-degree atrioventricular block (AVB) during the acute phase and assess for predictive factors. RESULTS: Thirty-two patients met inclusion criteria. Median age at admission was 9 years. Six of 32 patients (19%) were found to have first-degree AVB, with a median longest PR interval of 225 milliseconds (interquartile range 200-302), compared with 140 milliseconds (interquartile range 80-178) in patients without first-degree AVB. The onset of AVB occurred at a median of 8 days after the initial symptoms and returned to normal 3 days thereafter. No patients developed advanced AVB, although 1 patient developed a PR interval >300 milliseconds. Another patient developed new-onset right bundle branch block, which resolved during hospitalization. Cardiac enzymes, inflammatory markers, and cardiac function were not associated with AVB development. CONCLUSIONS: In our population, there is a 19% prevalence of first-degree AVB in patients with MIS-C. All patients with a prolonged PR interval recovered without progression to high-degree AVB. Patients admitted with MIS-C require close electrocardiogram monitoring during the acute phase.