Assessing ECG Findings in Pediatric COVID-19 Patients: A Comprehensive Analysis.

INTRODUCTION

COVID-19 can be associated with varying degrees of cardiac involvement in children, such that myocardial damage can be caused directly by the COVID-19 virus itself or systemic inflammation caused by the infection. The present study was conducted with the aim of evaluating ECG findings in children with COVID-19.

METHODS

This is a prospective cross-sectional study that was conducted by census method on 764 children with COVID-19 in hospitals related to Mashhad University of Medical Sciences in 2022. The data were extracted using a checklist including clinical information and medical records of the patients and analyzed using descriptive and statistical tests.

RESULTS

764 children with COVID-19 were examined, of which 385 (51%) were male. The studied patients included MISC (25.9%), Kawasaki-like disease (0.3%), pulmonary (12.7%), and gastrointestinal (2%) involvements. More than half of the patients (58%, 444 patients) showed changes in echocardiography findings, including mitral valve insufficiency, dilation of one or more cardiac chambers, and pericardial effusion. 98.8% of patients had NAX. AVB grade I was found in 26 patients (3.4%). Abnormal ST-T segments were observed in 25 patients (3.3%). The prevalence rate of S wave fragmentation was 2.8% (21), and fragmented R waves were found in 13 patients (1.7%).

DISCUSSION: Patients hospitalized in the intensive care unit (ICU) had a higher amount of disorder for each parameter change. Additionally, a significant association was found between the higher occurrence of AV node block and arrhythmia with clinical status (p<0.05), with the same higher rate in patients kept in the ICU.

CONCLUSION

ECG findings can be used to predict the presence or absence of myocardial involvement as well as its severity. Furthermore, patients with changes in ST-T fQRS and PR interval are more likely to experience cardiac involvement, which could result in a poorer prognosis.