Audrey Dionne, Harvard Medical School
Kevin G. Friedman, Harvard Medical School
Cameron C. Young, Children's Hospital Boston
Margaret M. Newhams, Children's Hospital Boston
Suden Kucukak, Children's Hospital Boston
Ashley M. Jackson, Centers for Disease Control and Prevention
Julie C. Fitzgerald, University of Pennsylvania Perelman School of Medicine
Laura S. Smallcomb, Medical University of South Carolina
Sabrina Heidemann, Central Michigan University
Gwenn E. McLaughlin, University of Miami Leonard M. Miller School of Medicine
Katherine Irby, Arkansas Children's Hospital
Tamara T. Bradford, LSU Health Sciences Center - New OrleansFollow
Steven M. Horwitz, Rutgers Robert Wood Johnson Medical School
Laura L. Loftis, Texas Children's Hospital Houston
Vijaya L. Soma, NYU Grossman School of Medicine
Courtney M. Rowan, Indiana University School of Medicine
Michele Kong, The University of Alabama at Birmingham
Natasha B. Halasa, Vanderbilt University Medical Center
Keiko M. Tarquinio, Emory University School of Medicine
Adam J. Schwarz, CHOC Children‘s UC Irvine School of Medicine
Janet R. Hume, University of Minnesota Twin Cities
Shira J. Gertz, Cooperman Barnabas Medical Center
Katharine N. Clouser, Hackensack Meridian School of Medicine
Christopher L. Carroll, Connecticut Children's Medical Center
Kari Wellnitz, University of Iowa Carver College of Medicine
Melissa L. Cullimore, Children's Hospital and Medical Center
Sule Doymaz, SUNY Downstate Health Sciences University
Emily R. Levy, Mayo Clinic

Document Type


Publication Date


Publication Title

Journal of the American Heart Association


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 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.

PubMed ID






File Format


File Size

1675 KB

Included in

Pediatrics Commons