CARDIAC SCREENING AFTER COVID-19 INFECTION IN CHILDREN: IS ELECTROCARDIOGRAM WARRANTED?

Background

The risk of cardiac sequelae after COVID-19 infection in children is unknown. Our objective was to determine the utility of cardiac screening in children after COVID-19 infection

Methods

We reviewed the cardiac evaluations of children referred after COVID-19 infection to one of our 23 clinics throughout the state between August 6th and October 30th, 2020. We excluded children with a history of Multisystem Inflammatory Syndrome or unrepaired congenital heart disease. Children could be referred for an ECG-only visit or a full clinic visit, with further evaluation as indicated.

Results

Of 206 children referred to cardiology following COVID-19 infection (Figure), 41% were female, 84% were non-Hispanic white, and median age was 16 years (range 3-21 years). Cardiac symptoms were present in 26 children (13%). ECG was normal in 95%, with 28% having sinus bradycardia. Echocardiogram was normal in all 36 who received it. Concerning cardiac pathology was noted in only one patient, a child with ventricular ectopy on ECG and exam.

Conclusion

In this population of children, cardiac sequelae following COVID-19 was rare and was detectable on physical exam. Based on these findings, children without cardiac signs or symptoms following COVID-19 may not need further cardiac evaluation.