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Atrioventricular Block in Children With Multisystem Inflammatory Syndrome
- Source :
- Pediatrics. 146
- Publication Year :
- 2020
- Publisher :
- American Academy of Pediatrics (AAP), 2020.
-
Abstract
- BACKGROUND: Children are at risk for multisystem inflammatory syndrome in children (MIS-C) after infection with severe acute respiratory syndrome coronavirus 2. Cardiovascular complications, including ventricular dysfunction and coronary dilation, are frequent, but there are limited data on arrhythmic complications. METHODS: Retrospective cohort study of children and young adults aged ≤21 years admitted with MIS-C. Demographic characteristics, electrocardiogram (ECG) and echocardiogram findings, and hospital course were described. RESULTS: Among 25 patients admitted with MIS-C (60% male; median age 9.7 [interquartile range 2.7–15.0] years), ECG anomalies were found in 14 (56%). First-degree atrioventricular block (AVB) was seen in 5 (20%) patients a median of 6 (interquartile range 5–8) days after onset of fever and progressed to second- or third-degree AVB in 4 patients. No patient required intervention for AVB. All patients with AVB were admitted to the ICU (before onset of AVB) and had ventricular dysfunction on echocardiograms. All patients with second- or third-degree AVB had elevated brain natriuretic peptide levels, whereas the patient with first-degree AVB had a normal brain natriuretic peptide level. No patient with AVB had an elevated troponin level. QTc prolongation was seen in 7 patients (28%), and nonspecific ST segment changes were seen in 14 patients (56%). Ectopic atrial tachycardia was observed in 1 patient, and none developed ventricular arrhythmias. CONCLUSIONS: Children with MIS-C are at risk for atrioventricular conduction disease, especially those who require ICU admission and have ventricular dysfunction. ECGs should be monitored for evidence of PR prolongation. Continuous telemetry may be required in patients with evidence of first-degree AVB because of risk of progression to high-grade AVB.
- Subjects :
- Male
medicine.medical_specialty
Adolescent
Pneumonia, Viral
Disease
Betacoronavirus
Young Adult
03 medical and health sciences
0302 clinical medicine
Risk Factors
Interquartile range
030225 pediatrics
Internal medicine
Humans
Medicine
ST segment
cardiovascular diseases
Young adult
Atrioventricular Block
Child
Pandemics
Retrospective Studies
biology
SARS-CoV-2
business.industry
Infant, Newborn
COVID-19
Infant
Retrospective cohort study
Brain natriuretic peptide
medicine.disease
Troponin
Systemic Inflammatory Response Syndrome
Child, Preschool
Pediatrics, Perinatology and Child Health
Cardiology
biology.protein
Female
Coronavirus Infections
business
Atrioventricular block
Follow-Up Studies
Subjects
Details
- ISSN :
- 10984275 and 00314005
- Volume :
- 146
- Database :
- OpenAIRE
- Journal :
- Pediatrics
- Accession number :
- edsair.doi.dedup.....9edb47d55fae0be9e3449f4d093925be