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Evaluation of Electrocardiographic Changes and Laboratory Parameters in Pediatric COVID-19

Yıl 2020, , 541 - 548, 15.12.2020
https://doi.org/10.31832/smj.784180

Öz

Objective: Cardiac involvement of Coronavirus 19 disease (COVID-19) may be reflected by electrocardiographic (ECG) changes. ECG changes that may occur in hospital admission for COVID-19 in children have not yet been fully evaluated.
Materials-Methods: We examined 83 children admitted to our hospital with proven COVID-19. A detailed clinical examination, 12-lead ECG and laboratory tests were recorded. And then all laboratory parameters were evaluated by age.
Results: P wave amplitude was normal in 77.1% and high in 22.9% of study population. There was a significant difference in white blood cell (WBC), lymphocyte, neutrophil, aspartate aminotransferase (AST), lactate dehydrogenase (LDH), D-dimer values between the group with P wave amplitude normal and the high group. 13.3% of patients had first degree AV block and 86.7% did not. There was a significant difference between the groups in WBC, lymphocyte, D-dimer, AST values. In our study, there was right ventricular hypertrophy (RVH) in the ECG of 17 cases. There was a significant difference in WBC, lymphocyte, D-dimer, LDH, AST values between groups with and without RVH. In addition, there were positive correlations among V1R, V6S, V1 R / S ratio and WBC, lymphocyte, D-dimer, creatinine kinase (CK), creatinine kinase isoform MB (CK-MB), LDH, AST values.
Conclusions: Pathological ECG findings were associated with laboratory values used in the course of the disease. We think that ECG is a test in the course of COVID-19 in children, which may make important contributions to clinicians to manage the patients when interpreted correctly.

Kaynakça

  • 1. Wu Z, Mcgoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA, 2020,5:13.24-32 PMID: 32091533 doi: 10.1001/jama.2020.2648.
  • 2. Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F et al. Association of cardiac injury with mortality in hospitalized. JAMA Cardiol. 2020, 5:802-10. doi: 10.1001/jamacardio.2020.0950.
  • 3. Myung K. Park MD, FAAP, FACC and Mehrdad Salamat MD, FAAP, FACC. Electrocardiography. Park's Pediatric Cardiology for Practitioners, 2020,3,31-49.
  • 4. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020, 395:497-506. doi: 10.1016/S0140-6736(20)30183.
  • 5. Fan BE, Chong VCL, Chan SSW, Lim GH, Lim KGE, Tan G et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol. 2020, 95,6:E131-E134. doi: 10.1002/ajh.25774.
  • 6. Xu XW, Wu XX, Jiang XG, Xu KJ, Ying LJ, Ma CL et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. 2020 368:m606. PMID: 32075786.
  • 7. Lippi G, Plebani M. The critical role of laboratory medicine during coronavirus disease 2019 (COVID19) and other viral outbreaks. Clin Chem Lab Med. 2020, 58,7:1063-1069. doi: 10.1515/cclm-2020-0240.
  • 8. Huijing Ma, Jiani Hu , Jie Tian, Zhou X, Laws MT, Wesemann LD et al. A Single-Center, Retrospective Study of COVID-19 Features in Children: A Descriptive Investigation. BMC Med. 2020, 18,1:123. doi:10.1186/s12916-020-01596-9.
  • 9. Zheng F, Liao C, Fan QH, Chen H, Zhou X, Xie Z et al. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci. 2020. 40,2:1-6 doi:10.1007/s11596-020-2172-6.
  • 10. Guan WJ, Ni ZY, Hu Y, Liang W, Ou C, He J et al. Clinical characteristics of 2019 novel coronavirus infection in China. NEJM. 2020. PMID: 32109013 doi:10.1056/NEJMoa2002032.
  • 11. Henry BM, Lippi G, Plebani M. Laboratory abnormalities in children with novel coronavirus disease. Clin Chem Lab Med. 2020,58,7:1135-1138. doi: 10.1515/cclm-2020-0272 .
  • 12. Steven Douedi, Hani Douedi . P wave. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing ve 31869099, 2020 Jan. PMID: 31869099.
  • 13. Bitnun A, Allen H, Heurter H, King SM, Opavsky MA, Ford-Jones E et al. Children hospitalized with severe acute respiratory syndrome-related illness in Toronto. Pediatrics. 2003 112,4:e261. doi: 10.1542/peds.112.4.e261.
  • 14. Xiong H.F, Wang L, Li X.H. Clinical features of 31 children's SARS cases in Beijing. Chinese journal of pediatrics 41,8:574-7. PMID: 14744375.
  • 15. Duan H.M., Shen K.L. Study on the relationship between characteristics and immunity of SARS in children. China Pediatr Emerg Med. 2006,13,3:281–282.
  • 16. Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J et al. Clinical and Biochemical Indexes From 2019-nCoV Infected Patients Linked to Viral Loads and Lung Injury. Sci China Life Sci. 2020,9,63,3:364-374. doi: 10.1007/s11427-020-1643-8.
  • 17. Guo T, Fan Y, Chen M, Wu X, Zhang L, He T et al. Cardiovascular implications of fatal outcomes of patients. JAMA Cardiol. 2020 Mar 27, 5,7:1-8 doi: 10.1001/jamacardio.2020.1017.

Pediyatrik COVID-19'da Elektrokardiyografi Değişiklikleri ve Laboratuvar Parametrelerinin Değerlendirilmesi

Yıl 2020, , 541 - 548, 15.12.2020
https://doi.org/10.31832/smj.784180

Öz

Amaç: Koronavirüs 19 hastalığının (COVID-19) kardiyak tutulumu elektrokardiyografik (EKG) değişikliklerle yansıtılabilir. Çocuklarda COVID-19 nedeniyle hastane başvurularında meydana gelebilecek EKG değişiklikleri henüz tam olarak değerlendirilmemiştir.
Gereç ve Yöntemler: Kanıtlanmış COVID-19 tanısı ile hastaneye başvuran 83 çocuk değerlendirildi. Ayrıntılı klinik muayene, 12 derivasyonlu EKG ve laboratuvar testleri kaydedildi. Tüm laboratuvar değerleri yaşa göre değerlendirildi.
Bulgular: P dalga amplitüdü çalışma popülasyonunun% 77.1'inde normal ve% 22.9'unda yüksek bulundu. P dalga amplitüdü normal olan grup ile yüksek grup arasında beyaz kan hücresi (WBC), lenfosit, nötrofil, aspartat aminotransferaz (AST), laktat dehidrojenaz (LDH), D-dimer değerlerinde anlamlı fark vardı. Hastaların % 13.3'ünde birinci derece AV blok varken % 86.7'sinde yoktu. Birinci derece AV blok olan ve olmayan gruplar arasında WBC, lenfosit, D-dimer, AST değerlerinde anlamlı fark vardı. Çalışmamızda 17 olgunun EKG'sinde sağ ventrikül hipertrofisi (RVH) vardı. RVH olan ve olmayan gruplar arasında WBC, lenfosit, D-dimer, LDH, AST değerlerinde anlamlı farklılık vardı. Ayrıca V1R, V6S, V1 R / S oranı ile WBC, lenfosit, D-dimer, kreatinin kinaz (CK), kreatinin kinaz izoform MB (CK-MB), LDH, AST değerleri arasında pozitif korelasyon saptandı.
Sonuç: Patolojik EKG bulguları hastalığın seyrinde kullanılan laboratuvar değerleri ile ilişkilendirildi. EKG’nin çocuklarda COVID-19 seyrinde çok önemli bir test olduğunu ve doğru yorumlandığında klinisyenlerin hasta yönetimlerine ciddi katkılar sağlayabileceğini düşünüyoruz.

Kaynakça

  • 1. Wu Z, Mcgoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA, 2020,5:13.24-32 PMID: 32091533 doi: 10.1001/jama.2020.2648.
  • 2. Shi S, Qin M, Shen B, Cai Y, Liu T, Yang F et al. Association of cardiac injury with mortality in hospitalized. JAMA Cardiol. 2020, 5:802-10. doi: 10.1001/jamacardio.2020.0950.
  • 3. Myung K. Park MD, FAAP, FACC and Mehrdad Salamat MD, FAAP, FACC. Electrocardiography. Park's Pediatric Cardiology for Practitioners, 2020,3,31-49.
  • 4. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020, 395:497-506. doi: 10.1016/S0140-6736(20)30183.
  • 5. Fan BE, Chong VCL, Chan SSW, Lim GH, Lim KGE, Tan G et al. Hematologic parameters in patients with COVID-19 infection. Am J Hematol. 2020, 95,6:E131-E134. doi: 10.1002/ajh.25774.
  • 6. Xu XW, Wu XX, Jiang XG, Xu KJ, Ying LJ, Ma CL et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. 2020 368:m606. PMID: 32075786.
  • 7. Lippi G, Plebani M. The critical role of laboratory medicine during coronavirus disease 2019 (COVID19) and other viral outbreaks. Clin Chem Lab Med. 2020, 58,7:1063-1069. doi: 10.1515/cclm-2020-0240.
  • 8. Huijing Ma, Jiani Hu , Jie Tian, Zhou X, Laws MT, Wesemann LD et al. A Single-Center, Retrospective Study of COVID-19 Features in Children: A Descriptive Investigation. BMC Med. 2020, 18,1:123. doi:10.1186/s12916-020-01596-9.
  • 9. Zheng F, Liao C, Fan QH, Chen H, Zhou X, Xie Z et al. Clinical characteristics of children with coronavirus disease 2019 in Hubei, China. Curr Med Sci. 2020. 40,2:1-6 doi:10.1007/s11596-020-2172-6.
  • 10. Guan WJ, Ni ZY, Hu Y, Liang W, Ou C, He J et al. Clinical characteristics of 2019 novel coronavirus infection in China. NEJM. 2020. PMID: 32109013 doi:10.1056/NEJMoa2002032.
  • 11. Henry BM, Lippi G, Plebani M. Laboratory abnormalities in children with novel coronavirus disease. Clin Chem Lab Med. 2020,58,7:1135-1138. doi: 10.1515/cclm-2020-0272 .
  • 12. Steven Douedi, Hani Douedi . P wave. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing ve 31869099, 2020 Jan. PMID: 31869099.
  • 13. Bitnun A, Allen H, Heurter H, King SM, Opavsky MA, Ford-Jones E et al. Children hospitalized with severe acute respiratory syndrome-related illness in Toronto. Pediatrics. 2003 112,4:e261. doi: 10.1542/peds.112.4.e261.
  • 14. Xiong H.F, Wang L, Li X.H. Clinical features of 31 children's SARS cases in Beijing. Chinese journal of pediatrics 41,8:574-7. PMID: 14744375.
  • 15. Duan H.M., Shen K.L. Study on the relationship between characteristics and immunity of SARS in children. China Pediatr Emerg Med. 2006,13,3:281–282.
  • 16. Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J et al. Clinical and Biochemical Indexes From 2019-nCoV Infected Patients Linked to Viral Loads and Lung Injury. Sci China Life Sci. 2020,9,63,3:364-374. doi: 10.1007/s11427-020-1643-8.
  • 17. Guo T, Fan Y, Chen M, Wu X, Zhang L, He T et al. Cardiovascular implications of fatal outcomes of patients. JAMA Cardiol. 2020 Mar 27, 5,7:1-8 doi: 10.1001/jamacardio.2020.1017.
Toplam 17 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Makaleler
Yazarlar

Pınar Dervişoğlu 0000-0001-5726-0362

Bahri Elmas 0000-0001-9034-6109

Öner Özdemir 0000-0002-5338-9561

Mehmet Fatih Orhan 0000-0001-8081-6760

Yayımlanma Tarihi 15 Aralık 2020
Gönderilme Tarihi 24 Ağustos 2020
Yayımlandığı Sayı Yıl 2020

Kaynak Göster

AMA Dervişoğlu P, Elmas B, Özdemir Ö, Orhan MF. Evaluation of Electrocardiographic Changes and Laboratory Parameters in Pediatric COVID-19. Sakarya Tıp Dergisi. Aralık 2020;10(4):541-548. doi:10.31832/smj.784180

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