Assessing ECG Findings in Pediatric COVID-19 Patients: A Comprehensive Analysis
Mohammadreza Naghibi1, Shirin Sadat Ghiasi2, Rasoul Raesi3,4
1Pediatric Interventional Cardiology, Pediatric and Congenital Cardiology Division, Pediatric Department, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Insights
Electrocardiogram (ECG) findings in children with COVID-19 can indicate myocardial damage. Abnormal ECG results, particularly ST-T changes, are linked to more severe cardiac involvement and poorer outcomes.
Area of Science:
- Pediatric Cardiology
- Infectious Diseases
- Medical Diagnostics
Background:
- COVID-19 can cause myocardial damage in children through direct viral effects or systemic inflammation.
- Assessing cardiac involvement in pediatric COVID-19 cases is crucial for understanding disease progression and potential complications.
Purpose of the Study:
- To evaluate the electrocardiogram (ECG) findings in a cohort of children diagnosed with COVID-19.
- To determine the association between specific ECG abnormalities and the severity of cardiac involvement in pediatric COVID-19 patients.
Main Methods:
- A prospective cross-sectional study involving 764 children with COVID-19.
- Data collection included clinical information and medical records, analyzed using descriptive and statistical tests.
Main Results:
- Over half of the patients (58%) exhibited echocardiographic changes, including valve insufficiency and pericardial effusion.
- ECG abnormalities were noted, such as AV node block (3.4%) and abnormal ST-T segments (3.3%).
- Patients in the intensive care unit (ICU) showed a higher prevalence of ECG parameter changes.
Conclusions:
- ECG findings are valuable for predicting the presence and severity of myocardial involvement in pediatric COVID-19.
- Abnormalities in ST-T segments and PR intervals suggest a higher likelihood of cardiac involvement and potentially a worse prognosis.
- A significant association exists between AV node block, arrhythmia, and clinical status, particularly in critically ill pediatric patients.
Introduction:
COVID-19 can be associated with varying degrees of cardiac involvement in children, such that myocardial damage can be caused directly by the COVID-19 virus itself or systemic inflammation caused by the infection. The present study was conducted with the aim of evaluating ECG findings in children with COVID-19.
Methods:
This is a prospective cross-sectional study that was conducted by census method on 764 children with COVID-19 in hospitals related to Mashhad University of Medical Sciences in 2022. The data were extracted using a checklist including clinical information and medical records of the patients and analyzed using descriptive and statistical tests.
Results:
764 children with COVID-19 were examined, of which 385 (51%) were male. The studied patients included MISC (25.9%), Kawasaki-like disease (0.3%), pulmonary (12.7%), and gastrointestinal (2%) involvements. More than half of the patients (58%, 444 patients) showed changes in echocardiography findings, including mitral valve insufficiency, dilation of one or more cardiac chambers, and pericardial effusion. 98.8% of patients had NAX. AVB grade I was found in 26 patients (3.4%). Abnormal ST-T segments were observed in 25 patients (3.3%). The prevalence rate of S wave fragmentation was 2.8% (21), and fragmented R waves were found in 13 patients (1.7%).
Discussion:
Patients hospitalized in the intensive care unit (ICU) had a higher amount of disorder for each parameter change. Additionally, a significant association was found between the higher occurrence of AV node block and arrhythmia with clinical status (p<0.05), with the same higher rate in patients kept in the ICU.
Conclusion:
ECG findings can be used to predict the presence or absence of myocardial involvement as well as its severity. Furthermore, patients with changes in ST-T fQRS and PR interval are more likely to experience cardiac involvement, which could result in a poorer prognosis.
More Related Videos
10:22Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
Published on: December 6, 2016
08:12Calculating Heart Rate Variability from ECG Data from Youth with Cerebral Palsy During Active Video Game Sessions
Published on: June 5, 2019
Related Concept Videos
01:29Electrocardiogram
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
01:24ECG Interpretation of Rhythms
Components of the Electrocardiogram
The primary components of a normal ECG waveform in Normal sinus rhythm(NSR) include the P wave, PR interval, QRS complex, ST segment, T wave, and occasionally a U wave.
ECG waveforms are divided by vertical and horizontal lines at standard intervals.
The horizontal axis measures time and rate, and the vertical axis measures amplitude or voltage....
01:28Electrocardiogram Fundamentals
An electrocardiogram (ECG) is a diagnostic tool for identifying cardiac conditions such as arrhythmias, conduction abnormalities, and myocardial ischemia.
Definition
An electrocardiogram (ECG) visualizes the heart's electrical activity by tracing the electrical movement associated with each heartbeat on a graph or monitor. As the heart beats, an electrical wave passes through it, correlating with the cardiac cycle events.
Parts of an ECG
An ECG utilizes electrodes on the skin...
01:25Correlation between ECG and Cardiac Cycle
A cardiac action potential originates in the SA node and spreads throughout the atria and the AV node in approximately 0.03 seconds. This results in the P wave in an ECG and triggers atrial contraction. The action potential is then briefly slowed at the AV node, allowing the atria to contract and fill the ventricles with blood before...
01:25ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
01:16ECG Interpretation of Arrhythmias I: Sinus Arrhythmias
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism,...