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Assessment of Cardiac Arrhythmic Risk in Children With Covid-19 Infection

İbrahim Ece1, Mücahit Koçoğlu2, Ahmet Vedat Kavurt2

  • 1Faculty of Medicine, Department of Pediatric Cardiology, Ankara City Hospital, University of Health Sciences, Ankara, Turkey. dribrahimece@gmail.com.

Pediatric Cardiology
|October 2, 2020
PubMed

Insights

COVID-19 infection impairs ventricular repolarization in children, even with mild or no symptoms. This study found prolonged QT dispersion and elevated Tp-e intervals, indicating potential long-term cardiac risks.

Area of Science:

  • Cardiology
  • Pediatrics
  • Infectious Diseases

Background:

  • COVID-19 (Coronavirus disease 2019) presents significant global morbidity and mortality, with cardiac complications increasingly reported.
  • The mechanisms of COVID-19-related cardiac injury and arrhythmias remain unclear, compounded by potential proarrhythmic effects of treatments.
  • Ventricular repolarization abnormalities, including QT interval prolongation, are a concern in COVID-19 patients.

Purpose of the Study:

  • To investigate the impact of asymptomatic and mild COVID-19 on trans-myocardial repolarization parameters in children.
  • To assess cardiac electrical activity changes in pediatric COVID-19 patients not receiving treatment.
  • To evaluate specific electrocardiographic markers of repolarization in a pediatric cohort with COVID-19.

Main Methods:

  • Comparison of 105 COVID-19 pediatric patients with 40 healthy children using 12-lead surface electrocardiograms.
  • Calculation and analysis of QT interval, corrected QT (QTc), QT dispersion (QTd), QTc dispersion (QTcd), Tp-e interval, Tp-e dispersion, Tp-e/QT ratio, and Tp-e/QTc ratio.
  • Statistical comparison of repolarization parameters between the COVID-19 group and the healthy control group.

Main Results:

  • Children with COVID-19 exhibited statistically significant increases in QT dispersion (QTd), QTc dispersion (QTcd), Tp-e interval, Tp-e dispersion, Tp-e/QT ratio, and Tp-e/QTc ratio compared to controls.
  • Ventricular repolarization was demonstrably impaired in asymptomatic children infected with COVID-19.
  • The mean age of participants was 11.2 ± 0.3 years in the patient group and 10.8 ± 2.1 years in the control group.

Conclusions:

  • COVID-19 infection, even in its asymptomatic or mild forms, can lead to impaired ventricular repolarization in children.
  • Elevated QT dispersion and Tp-e parameters suggest a potential for cardiac electrical instability.
  • Further investigation into the long-term risks associated with prolonged QT dispersion in pediatric COVID-19 survivors is warranted.

Keywords:
ArrhythmiaCOVID-19Cardiovascular systemMyocardial damage

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