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Case Reports
. 2021 Jul;36(7):2578-2581.
doi: 10.1111/jocs.15574. Epub 2021 Apr 16.

Tachyarrhythmia as a possible symptom of coronavirus in a neonate diagnosed with transposition of the great arteries

Raymond A Lopez  1 , Luz A Padilla  2 , Robert A Sorabella  2 , David C Cleveland  2 , Leslie A Rhodes  3 , Robert J Dabal  2
Affiliations
Case Reports

Tachyarrhythmia as a possible symptom of coronavirus in a neonate diagnosed with transposition of the great arteries

Raymond A Lopez et al. J Card Surg. 2021 Jul.

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic poses broad challenges to healthcare systems and providers. The manifestations of this disease are still being described in a variety of different contexts and patient populations.

Results: We report the case of a neonate who demonstrated COVID-19 after surgical correction of transposition of the great arteries. In addition, the patient demonstrated an evolving and persistent tachyarrhythmia consistent with neither the most likely postoperative complications nor typical COVID-19.

Discussion: The patient had negative preoperative testing for the virus and presented with profound oxygen desaturation and respiratory failure several days postoperatively. This raised concern for a complication of his arterial switch operation. It was found that one of the patient's caregivers was an asymptomatic carrier of COVID-19, and imaging ruled out intracardiac shunting. After initiating treatment for COVID-19, the patient's oxygen requirements and need for anti-arrhythmic agents improved.

Conclusion: We propose that, despite negative preoperative testing, coronavirus infection may present as refractory tachyarrhythmia, and may be considered along with surgical complications as a cause for unexplained hypoxemia postoperatively.

Keywords: COVID-19; congenital heart disease; cyanotic congenital heart disease; tachyarrhythmia; transposition of the great arteries.

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Conflict of interest statement

The authors declare that there are no conflict of interests.

Figures

Figure 1
Figure 1
Oxygen saturations measured each day postoperatively. The patient's respiratory failure occurred on a postoperative day (POD) 12, as demonstrated by the steep decline to 40%. Saturations could not be elevated much beyond 80% for 8 days afterward, before finally surpassing 90% on POD 21 [Color figure can be viewed at wileyonlinelibrary.com]
Figure 2
Figure 2
(A) AP chest X‐ray on the day of surgery reported clear lungs, stable cardiac enlargement, no pleural effusions or pneumothorax is seen. (B) AP chest X‐ray on postoperative day 12 reported the stable appearance of patchy added densities of the right upper and left lower lobe
See this image and copyright information in PMC

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