Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease (Oct 2022)
Tachyarrhythmias During Hospitalization for COVID‐19 or Multisystem Inflammatory Syndrome in Children and Adolescents
- Audrey Dionne,
- Kevin G. Friedman,
- Cameron C. Young,
- Margaret M. Newhams,
- Suden Kucukak,
- Ashley M. Jackson,
- Julie C. Fitzgerald,
- Laura S. Smallcomb,
- Sabrina Heidemann,
- Gwenn E. McLaughlin,
- Katherine Irby,
- Tamara T. Bradford,
- Steven M. Horwitz,
- Laura L. Loftis,
- Vijaya L. Soma,
- Courtney M. Rowan,
- Michele Kong,
- Natasha B. Halasa,
- Keiko M. Tarquinio,
- Adam J. Schwarz,
- Janet R. Hume,
- Shira J. Gertz,
- Katharine N. Clouser,
- Christopher L. Carroll,
- Kari Wellnitz,
- Melissa L. Cullimore,
- Sule Doymaz,
- Emily R. Levy,
- Katri V. Typpo,
- Amanda N. Lansell,
- Andrew D. Butler,
- Joseph D. Kuebler,
- Laura D. Zambrano,
- Angela P. Campbell,
- Manish M. Patel,
- Adrienne G. Randolph,
- Jane W. Newburger
Affiliations
- Audrey Dionne
- Department of Cardiology Boston Children’s Hospital Department of Pediatrics Harvard Medical School Boston MA
- Kevin G. Friedman
- Department of Cardiology Boston Children’s Hospital Department of Pediatrics Harvard Medical School Boston MA
- Cameron C. Young
- Department of Anesthesiology, Critical Care, and Pain Medicine Boston Children’s Hospital Boston MA
- Margaret M. Newhams
- Department of Anesthesiology, Critical Care, and Pain Medicine Boston Children’s Hospital Boston MA
- Suden Kucukak
- Department of Anesthesiology, Critical Care, and Pain Medicine Boston Children’s Hospital Boston MA
- Ashley M. Jackson
- COVID‐19 Response, Centers for Disease Control and Prevention Atlanta GA
- Julie C. Fitzgerald
- Division of Critical Care Department of Anesthesiology and Critical Care University of Pennsylvania Perelman School of Medicine Philadelphia PA
- Laura S. Smallcomb
- Department of Pediatrics Medical University of South Carolina Charleston SC
- Sabrina Heidemann
- Division of Pediatric Critical Care Medicine, Department of Pediatrics Central Michigan University Detroit MI
- Gwenn E. McLaughlin
- Division of Pediatric Critical Care Medicine Department of Pediatrics University of Miami Miller School of Medicine Miami FL
- Katherine Irby
- Section of Pediatric Critical Care Department of Pediatrics Arkansas Children’s Hospital Little Rock AR
- Tamara T. Bradford
- Division of Cardiology, Department of Pediatrics Louisiana State University Health Sciences Center and Children’s Hospital of New Orleans New Orleans LA
- Steven M. Horwitz
- Division of Pediatric Critical Care Medicine, Department of Pediatrics Rutgers Robert Wood Johnson Medical School New Brunswick NJ
- Laura L. Loftis
- Section of Critical Care Medicine Department of Pediatrics Texas Children’s Hospital Houston TX
- Vijaya L. Soma
- Division of Infectious Diseases, Department of Pediatrics New York University Grossman School of Medicine and Hassenfeld Children’s Hospital New York NY
- Courtney M. Rowan
- Division of Pediatric Critical Care Medicine Department of Pediatrics Indiana University School of Medicine Riley Hospital for Children Indianapolis IN
- Michele Kong
- Division of Pediatric Critical Care Medicine Department of Pediatrics University of Alabama at Birmingham Birmingham AL
- Natasha B. Halasa
- Division of Pediatric Infectious Diseases Department of Pediatrics Vanderbilt University Medical Center Nashville TN
- Keiko M. Tarquinio
- Division of Critical Care Medicine Department of Pediatrics Emory University School of Medicine Children’s Healthcare of Atlanta Atlanta GA
- Adam J. Schwarz
- Division of Critical Care Medicine CHOC Children’s Hospital Orange CA
- Janet R. Hume
- Division of Pediatric Critical Care University of Minnesota Masonic Children’s Hospital Minneapolis MN
- Shira J. Gertz
- Division of Pediatric Critical Care Department of Pediatrics Cooperman Barnabas Medical Center Livingston NJ
- Katharine N. Clouser
- Department of Pediatrics Hackensack Meridian School of Medicine Hackensack NJ
- Christopher L. Carroll
- Division of Critical Care Connecticut Children’s Medical Center Hartford CT
- Kari Wellnitz
- Division of Pediatric Critical Care Stead Family Department of Pediatrics University of Iowa Carver College of Medicine Iowa City IA
- Melissa L. Cullimore
- Division of Pediatric Critical Care Department of Pediatrics, Children’s Hospital and Medical Center Omaha NE
- Sule Doymaz
- Division of Pediatric Critical Care Department of Pediatrics SUNY Downstate Health Sciences University Brooklyn NY
- Emily R. Levy
- Divisions of Pediatric Infectious Diseases and Pediatric Critical Care Medicine Department of Pediatric and Adolescent Medicine, Mayo Clinic Rochester MN
- Katri V. Typpo
- Division of Pediatric Critical Care Department of Pediatrics University of Arizona Tucson AZ
- Amanda N. Lansell
- Division of Pediatric Hospital Medicine Rainbow Babies and Children’s Hospital Cleveland OH
- Andrew D. Butler
- Division of Pediatric Critical Care St. Christopher’s Hospital for Children Philadelphia PA
- Joseph D. Kuebler
- Division of Pediatric Critical Care Department of Pediatrics Golisano Children’s Hospital University of Rochester Rochester NY
- Laura D. Zambrano
- COVID‐19 Response, Centers for Disease Control and Prevention Atlanta GA
- Angela P. Campbell
- COVID‐19 Response, Centers for Disease Control and Prevention Atlanta GA
- Manish M. Patel
- COVID‐19 Response, Centers for Disease Control and Prevention Atlanta GA
- Adrienne G. Randolph
- Department of Anesthesiology, Critical Care, and Pain Medicine Boston Children’s Hospital Boston MA
- Jane W. Newburger
- Department of Cardiology Boston Children’s Hospital Department of Pediatrics Harvard Medical School Boston MA
- DOI
- https://doi.org/10.1161/JAHA.122.025915
- Journal volume & issue
-
Vol. 11,
no. 20
Abstract
Background Cardiac complications related to COVID‐19 in children and adolescents include ventricular dysfunction, myocarditis, coronary artery aneurysm, and bradyarrhythmias, but tachyarrhythmias are less understood. The goal of this study was to evaluate the frequency, characteristics, and outcomes of children and adolescents experiencing tachyarrhythmias while hospitalized for acute severe COVID‐19 or multisystem inflammatory syndrome in children. Methods and Results This study involved a case series of 63 patients with tachyarrhythmias reported in a public health surveillance registry of patients aged 1 type was reported in 12 (19%). Registry patients with versus without tachyarrhythmia were older (median age, 15.4 [range, 10.4–17.4] versus 10.0 [range, 5.4–14.8] years) and had higher illness severity on hospital admission. Intervention for treatment of tachyarrhythmia was required in 37 (59%) patients and included antiarrhythmic medication (n=31, 49%), electrical cardioversion (n=11, 17%), cardiopulmonary resuscitation (n=8, 13%), and extracorporeal membrane oxygenation (n=9, 14%). Patients with tachyarrhythmias had longer hospital length of stay than those who did not, and 9 (14%) versus 77 (2%) died. Conclusions Tachyarrhythmias were a rare complication of acute severe COVID‐19 and multisystem inflammatory syndrome in children and adolescents and were associated with worse clinical outcomes, highlighting the importance of close monitoring, aggressive treatment, and postdischarge care.
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