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

Lopez, Raymond A.; Padilla, Luz A.; Sorabella, Robert A.; Cleveland, David C.; Rhodes, Leslie A.; Dabal, Robert J.

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.