Tachyarrhythmias During Hospitalization for COVID-19 or Multisystem Inflammatory Syndrome in Children and Adolescents

Overcoming COVID-19 Investigators

Research output: Contribution to journalArticlepeer-review


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 <21 years hospitalized from March 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.

Original languageEnglish (US)
Article numbere025915
JournalJournal of the American Heart Association
Issue number20
StatePublished - Oct 18 2022

Bibliographical note

Funding Information:
This study was funded by the Centers for Disease Control and Prevention under a contract to Boston Children’s Hospital (#75D30120C07725). The Centers for Disease Control and Prevention was involved with the design and conduct of the public health investigation and review and approval of the manuscript. They did not collect or manage the data, and they did not analyze the data for this subanalysis or assist with interpretation or prepare the manuscript.

Publisher Copyright:
© 2022 The Authors.


  • COVID-19
  • multisystem inflammatory syndrome in children (MIS-C)
  • tachyarrhythmia

PubMed: MeSH publication types

  • Journal Article
  • Research Support, U.S. Gov't, P.H.S.


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