Electrocardiographic Changes in Pediatric Patients with COVID-19

Abstract Background COVID-19 may present with cardiac involvement such as shock, elevated troponin or, pro- brain natriuretic peptide level, coronary artery involvement, ventricular dysfunction, and arrhythmia. The most frequent electrocardiographic findings are low QRS amplitude, nonspecific ST segment changes and T-wave abnormalities. PR interval prolongation and first-degree AV block are also common in patients with MIS-C. Aim of the Study To evaluate the electrocardiogram changes in pediatric patients with COVID-19. Patients and Methods The present study is a cross sectional study which included 75 patients with definite, probable or evidence of previous COVID-19 infection (based on positive PCR, IgM or IgG), who were admitted at El Demerdash Pediatrics Hospital. Each child had two electrocardiogram done (on presentation and on third day of admission). Results The median age of our population was five years. Thirty five were females and fourty were males. On presentation, our patients had regular rythm, bradycardia was found among 9 patients (12%) and tachycardia was found among 17 patients (22.7%). Four patients (5.3%) showed prolonged PR interval, one patient (1.3%)showed prolonged QRS complex, one patient showed Right axis deviation and four patients (5.3%) showed left axis deviation, prolonged QT interval was found among four patients(5.3%). Regarding T wave, there was inversion in V1 in 27 patients(37.5%) and inversion in v4 in 24 patients(32.9%). All these findings disappeared with follow up on day three of admission. Conclusion Electrocardiogram may represent a crucial test in the diagnosis of myocardial injury or heart rythm disturbances in patients with SARS-COV-2.