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Electrocardiographic changes in non-hospitalised children with COVID-19

Part of: Electrophysiology

Published online by Cambridge University Press:  06 January 2022

Howard J. Heching Open the ORCID record for Howard J. Heching [Opens in a new window] ,
Anmol Goyal ,
Brian Harvey ,
Lindsey Malloy-Walton ,
Christopher Follansbee Open the ORCID record for Christopher Follansbee [Opens in a new window] ,
Amanda Mcintosh  and
Daniel Forsha Open the ORCID record for Daniel Forsha [Opens in a new window]
Howard J. Heching
Affiliation:
Ward Family Heart Center, Children’s Mercy Kansas City, Kansas City, MO, USA Department of Pediatrics, University of Missouri – Kansas City School of Medicine, Kansas City, MO, USA
Anmol Goyal
Affiliation:
Ward Family Heart Center, Children’s Mercy Kansas City, Kansas City, MO, USA
Brian Harvey
Affiliation:
Department of Pediatrics, University of Missouri – Kansas City School of Medicine, Kansas City, MO, USA Division of Sports Medicine, Children’s Mercy Kansas City, Kansas City, MO, USA
Lindsey Malloy-Walton
Affiliation:
Ward Family Heart Center, Children’s Mercy Kansas City, Kansas City, MO, USA Department of Pediatrics, University of Missouri – Kansas City School of Medicine, Kansas City, MO, USA
Christopher Follansbee
Affiliation:
Ward Family Heart Center, Children’s Mercy Kansas City, Kansas City, MO, USA Department of Pediatrics, University of Missouri – Kansas City School of Medicine, Kansas City, MO, USA
Amanda Mcintosh
Affiliation:
Ward Family Heart Center, Children’s Mercy Kansas City, Kansas City, MO, USA Department of Pediatrics, University of Missouri – Kansas City School of Medicine, Kansas City, MO, USA
Daniel Forsha*
Affiliation:
Ward Family Heart Center, Children’s Mercy Kansas City, Kansas City, MO, USA Department of Pediatrics, University of Missouri – Kansas City School of Medicine, Kansas City, MO, USA
*
Author for correspondence: D. Forsha, MD, Ward Family Heart Center, Children’s Mercy Kansas City, 2401 Gillham Road, Kansas City, MO 64108, USA. Tel: 303-921-5878; Fax: 816-302-9987. E-mail: deforsha@cmh.edu
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Abstract

Objectives:

Many children diagnosed with COVID-19 infections did not require hospitalisation. Our objective was to analyse electrocardiographic changes in children with asymptomatic, mild or moderate COVID-19 who did not require hospitalisation

Methods:

All children are seen in a paediatric cardiology clinic who had asymptomatic, mild or moderate COVID-19 that did not require hospitalisation and had at least one electrocardiogram after their diagnosis were included in this retrospective analysis. Records were reviewed to determine COVID-19 disease severity and presence of Long COVID. Rhythm assessment, atrial enlargement, ventricular hypertrophy, PR/QRS/QT interval duration and ST-T wave abnormalities were analysed by a paediatric electrophysiologist. Clinically ordered echocardiograms were reviewed for signs of myopericarditis (left ventricular ejection fraction and pericardial effusion) on any subject with an electrocardiographic abnormality.

Results:

Of the 82 children meeting inclusion criteria (14.4 years, range 1–18 years, 57% male), 17 patients (21%) demonstrated electrocardiographic changes. Ten patients (12%) had electrocardiogram of borderline significance, which included isolated mild PR prolongation or mild repolarisation abnormalities. The other seven patients (9%) had concerning electrocardiographic findings consisting of more significant repolarisation abnormalities. None of the patients with an abnormal electrocardiogram revealed any echocardiographic abnormality. All abnormal electrocardiograms normalised over time except in two cases. Across the entire cohort, greater COVID-19 disease severity and long COVID were not associated with electrocardiographic abnormalities.

Conclusions:

Electrocardiographic abnormalities are present in a minority of children with an asymptomatic, mild or moderate COVID-19 infection. Many of these changes resolved over time and no evidence of myopericarditis was present on echocardiography.

Keywords

EKGSARS-CoV-2arrhythmiascoronaviruspaediatric
Type
Original Article
Information
Cardiology in the Young , Volume 32 , Issue 12 , December 2022 , pp. 1910 - 1916
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Copyright
© The Author(s), 2022. Published by Cambridge University Press

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Footnotes

Howard J. Heching and Anmol Goyal are co-primary authors.

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