Refractory Atrial Flutter, the Only Presentation of covid-19 Infection in a Neonate: a case report and review of literature

Background The accurate incidence of different cardiovascular consequences of COVID-19 in pediatric population have been inadequately defined due to ongoing genotype changes in the virus. Although COVID-19 is known to increase inflammatory markers associated with atrial arrhythmias, the contemporary literature has poorly described new onset arrhythmias as a complication in previously healthy neonate with COVID-19 Case presentation Twenty-day-old female term neonate, born by caesarean section with immediate cry developed labored breathing, cyanosis and tachycardia after having close contact with a confirmed case of covid-19. She developed atrial flutter, which was refractory to cardioversion and drugs namely Amiodarone, Flecainide and Propranolol. The neonate was treated with IVIG. This is the first reported case of atrial flutter in neonatal period secondary to COVID-19. Conclusion Since the starting of SARS –COV2 pandemic all attentions and concerns has been mainly on respiratory manifestations and complications. The cardiovascular complications and treatment are neglected. This case reports tachyarrhythmia (Atrial Flutter) as unusual presentation of MISC in neonatal population and show role of IvIg in treatment of refractory arrhythmias.