Tachyarrhythmias During Hospitalization for COVID-19 or Multisystem Inflammatory Syndrome in Children and Adolescents

被引：7

作者：

Dionne, Audrey ^{[1
]}

Friedman, Kevin G. ^{[1
]}

Young, Cameron C. ^{[2
]}

Newhams, Margaret M. ^{[2
]}

Kucukak, Suden ^{[2
]}

Jackson, Ashley M. ^{[3
]}

Fitzgerald, Julie C. ^{[4
]}

Smallcomb, Laura S. ^{[5
]}

Heidemann, Sabrina ^{[6
]}

McLaughlin, Gwenn E. ^{[7
]}

Irby, Katherine ^{[8
]}

Bradford, Tamara T. ^{[9
,10
]}

Horwitz, Steven M. ^{[11
]}

Loftis, Laura L. ^{[12
]}

Soma, Vijaya L. ^{[13
,14
]}

Rowan, Courtney M. ^{[15
]}

Kong, Michele ^{[16
]}

Halasa, Natasha B. ^{[17
]}

Tarquinio, Keiko M. ^{[18
]}

Schwarz, Adam J. ^{[19
]}

Hume, Janet R. ^{[20
]}

Gertz, Shira J. ^{[21
]}

Clouser, Katharine N. ^{[22
]}

Carroll, Christopher L. ^{[23
]}

Wellnitz, Kari ^{[24
]}

Cullimore, Melissa L. ^{[25
]}

Doymaz, Sule ^{[26
]}

Levy, Emily R. ^{[27
,28
]}

Typpo, Katri, V ^{[29
]}

Lansell, Amanda N. ^{[30
]}

Butler, Andrew D. ^{[31
]}

Kuebler, Joseph D. ^{[32
]}

Zambrano, Laura D. ^{[3
]}

Campbell, Angela P. ^{[3
]}

Patel, Manish M. ^{[3
]}

Randolph, Adrienne G. ^{[2
,33
,34
]}

Newburger, Jane W. ^{[1
]}

机构：

[1] Harvard Med Sch, Boston Childrens Hosp, Dept Cardiol, Dept Pediat, Boston, MA 02115 USA

[2] Boston Childrens Hosp, Dept Anesthesiol Crit Care & Pain Med, Boston, MA USA

[3] Ctr Dis Control & Prevent, COVID 19 Response, Atlanta, GA USA

[4] Univ Penn, Dept Anesthesiol & Crit Care, Div Crit Care, Perelman Sch Med, Philadelphia, PA USA

[5] Med Univ South Carolina, Dept Pediat, Charleston, SC USA

[6] Cent Michigan Univ, Dept Pediat, Div Pediat Crit Care Med, Detroit, MI USA

[7] Univ Miami, Dept Pediat, Div Pediat Crit Care Med, Miller Sch Med, Miami, FL USA

[8] Arkansas Childrens Hosp, Dept Pediat, Sect Pediat Crit Care, Little Rock, AR USA

[9] Louisiana State Univ, Dept Pediat, Div Cardiol, Hlth Sci Ctr, New Orleans, LA USA

[10] Childrens Hosp New Orleans, New Orleans, LA USA

[11] Rutgers Robert Wood Johnson Med Sch, Dept Pediat, Div Pediat Crit Care Med, New Brunswick, NJ USA

[12] Texas Childrens Hosp, Dept Pediat, Sect Crit Care Med, Houston, TX USA

[13] NYU, Dept Pediat, Div Infect Dis, Grossman Sch Med, New York, NY USA

[14] Hassenfeld Childrens Hosp, New York, NY USA

[15] Indiana Univ Sch Med, Riley Hosp Children, Dept Pediat, Div Pediat Crit Care Med, Indianapolis, IN USA

[16] Univ Alabama Birmingham, Dept Pediat, Div Pediat Crit Care Med, Birmingham, AL USA

[17] Vanderbilt Univ, Dept Pediat, Div Pediat Infect Dis, Med Ctr, Nashville, TN USA

[18] Emory Univ, Dept Pediat, Div Crit Care Med, Childrens Healthcare Atlanta,Sch Med, Atlanta, GA USA

[19] CHOC Childrens Hosp, Div Crit Care Med, Orange, CA USA

[20] Univ Minnesota, Div Pediat Crit Care, Masonic Childrens Hosp, Minneapolis, MN USA

[21] Cooperman Bamabas Med Ctr, Dept Pediat, Div Pediat Crit Care, Livingston, NJ USA

[22] Hackensack Meridian Sch Med, Dept Pediat, Hackensack, NJ USA

[23] Connecticut Childrens Med Ctr, Div Crit Care, Hartford, CT USA

[24] Univ Iowa, Stead Family Dept Pediat, Div Pediat Crit Care, Carver Coll Med, Iowa City, IA USA

[25] Childrens Hosp & Med Ctr, Dept Pediat, Div Pediat Crit Care, Omaha, NE USA

[26] SUNY Downstate Hlth Sci Univ, Dept Pediat, Div Pediat Crit Care, Brooklyn, NY USA

[27] Mayo Clin, Div Pediat Infect Dis, Dept Pediat & Adolescent Med, Rochester, MN USA

[28] Mayo Clin, Div Pediat Crit Care Med, Dept Pediat & Adolescent Med, Rochester, MN USA

[29] Univ Arizona, Dept Pediat, Div Pediat Crit Care, Tucson, AZ USA

[30] Rainbow Babies & Childrens Hosp, Div Pediat Hosp Med, Cleveland, OH USA

[31] St Christophers Hosp Children, Div Pediat Crit Care, Philadelphia, PA USA

[32] Univ Rochester, Golisano Childrens Hosp, Dept Pediat, Div Pediat Crit Care, Rochester, NY USA

[33] Harvard Med Sch, Dept Anaesthesia, Boston, MA 02115 USA

[34] Harvard Med Sch, Dept Pediat, Boston, MA 02115 USA

来源：

JOURNAL OF THE AMERICAN HEART ASSOCIATION | 2022年 / 11卷 / 20期

关键词：

COVID-19; multisystem inflammatory syndrome in children (MIS-C); tachyarrhythmia; SCIENTIFIC STATEMENT; ARRHYTHMIAS; MANAGEMENT; DIAGNOSIS;

D O I：

10.1161/JAHA.122.025915

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

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 <21 years hospitalized from March 15, 2020, to December 31, 2021, at 63 US hospitals. Patients with tachyarrhythmias were compared with patients with severe COVID-19-related complications without tachyarrhythmias. Tachyarrhythmias were reported in 22 of 1257 patients (1.8%) with acute COVID-19 and 41 of 2343 (1.7%) patients with multisystem inflammatory syndrome in children. They included supraventricular tachycardia in 28 (44%), accelerated junctional rhythm in 9 (14%), and ventricular tachycardia in 38 (60%); >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.

引用

页数：31

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