Diagnostic Difficulties in a Case of Fetal Ventricular Tachycardia Associated with Neonatal COVID Infection: Case Report

Abstract

The clinical course of COVID in the pediatric population is considered to be much milder when compared to adults; however, the occurrence of severe and fatal forms of the disease in children is non-negligible, especially in patients with comorbidities such as prematurity or cardiac disease. We report a case of a newborn with sotalol-controlled fetal ventricular tachycardia, who was postnatally diagnosed with COVID infection. The myocardial injury was sustained on the basis of pericardial effusion, left ventricular dysfunction, rapid progression to coronary artery dilation, and an arrhythmic storm. We believe that, in our case, there is a significant overlap between fetal ventricular tachycardia, associated with impaired left ventricular function, and COVID infection, diagnosed after birth; both factors contribute to the myocardial dysfunction with a fulminant clinical evolution. To our knowledge, this is the first case describing neonatal myocardial dysfunction associated with SARS-CoV infection complicating the clinical course of rare fetal tachyarrhythmia.

Fulminant Myocarditis with SARS-CoV-2 Infection: A Narrative Review from the Case Studies

“…Myocarditis has been reported to occur more frequently in males, with a male to female ratio around 1.5 : 1–1.7 : 1; therefore, the current review was consistent with previous reports [ 100 , 101 ]. Surprisingly, the case of a 3-day-old newborn with myocarditis was reported; if mothers do not possess antibodies against COVID-19, newborns can be infected with the virus [ 38 ]. Conversely, the incidence was not so high among the elderly.…”

Difficulties in diagnosis of SARS-CoV-2 myocarditis in an adolescent

“…However ventricular arrhythmia has been described in the setting of acute COVID-19 infection in childhood. Gozar et al described the case of a fetal and neonatal ventricular tachycardia associated with an acute neonatal COVID-19 infection [19]. A further case of a 5-year-old boy with a ventricular tachycardia from acute fulminant myocarditis secondary to acute COVID-19 infection has been described [20].…”