Features of electrocardiogram in school-age children with COVID-19

Abstract

Introduction. Currently, there is an increase in the incidence and an increase in the severity of the course of COVID-19 in children. The tropism of the SARS-CoV-2 virus to the cardiovascular system has been established, while post-COVID syndrome with various manifestations is recorded in 25% of recovered adolescents. The purpose of the work was to identify the features of the electrocardiogram (ECG) pattern in children hospitalized with a diagnosis of COVID-19. Results. Significant changes in the conductivity and activity of the left heart myocardium were found in COVID-19 patients with pneumonia and respiratory failure. Pronounced changes in ECG indices were found in children of senior school age who were admitted for treatment 2.4 times more often than other children. Proarrhythmogenic ECG indices in children were detected in severe COVID-19 - with community-acquired pneumonia (ΔQTc, QTcmin) and respiratory failure (TpTe/QTmax). These ECG changes, combined with the trend in inflammation markers (an increase in the C-reactive protein level and a decrease in the number of lymphocytes) in children with a moderate course of COVID-19 may be a sign of the involvement of the myocardium in an infectious inflammatory process. This suggests that the effect on the myocardium is exerted by systemic inflammation and not by the hemodynamic overload of the right heart, which is expected in pulmonary pathology. Conclusion. The obtained data indicate the need for dynamic ECG monitoring during the acute stage of the disease and rehabilitation of children who suffered from COVID-19.