• Sharmeen Samuel, Richard A Friedman, Chetan Sharma, Madhusudan Ganigara, Elizabeth Mitchell, Charles Schleien, and Andrew D Blaufox.
• Section of Pediatric Cardiology and; Department of Pediatrics, Cohen Children's Medical Center, Northwell Health System, Donald and Barbara Zucker School of Medicine at Hofstra University, New Hyde Park, New York. Electronic address: ssamuel21@northwell.edu.
• Heart Rhythm. 2020 Nov 1; 17 (11): 1960-1966.

BackgroundThere is limited data regarding the electrophysiological abnormalities and arrhythmias in children with COVID-19, including those associated with treatment using potentially proarrhythmic hydroxychloroquine (HCQ) and azithromycin (AZN).ObjectivesTo describe the electrophysiologic findings and arrhythmias associated with pediatric COVID-19 and its treatment.MethodsA single-center retrospective chart review was undertaken and included all patients with (1) symptoms of COVID-19 and (2) PCR-positive nasopharyngeal swabs for SARS-CoV-2 who were placed on continuous telemetry for the duration of their hospitalization during March through May, 2020.ResultsThirty-six patients were included in the study. Significant arrhythmias were found in 6 (nonsustained ventricular tachycardia in 5 and sustained atrial tachycardia in 1). All were self-resolving and half prompted prophylactic antiarrhythmic therapy. Patients with significant arrhythmias were likely to have noncardiac comorbidities (4/6), but these were not more common than in patients without arrhythmias (20/30, P = 1). The use of HCQ was associated with statistically significant QTc prolongation (413 ± 19 ms vs 425 ± 16 ms, P =.005). QTc was not statistically different in patients with and without arrhythmias (425 ± 15 ms vs 425 ± 15 ms, P = 1).ConclusionsIn pediatric patients with PCR-positive active COVID-19 infection, significant arrhythmias are infrequent, but are more common than expected in a general pediatric population. Comorbidities are not more common in patients with arrhythmias than in patients without arrhythmias. COVID-19 treatment using HCQ is associated with QTc prolongation but was not associated with arrhythmias in pediatric patients.Copyright © 2020 Heart Rhythm Society. Published by Elsevier Inc. All rights reserved.

51 keywords...

hide…