Refractory Atrial Flutter, the Unusual Presentation of Covid-19 Infection in a Neonate: ACase Report and Review of Literature

Introduction: the accurate incidence of different cardiovascular consequences of covid-19 in thepediatric population has been inadequately defined due to ongoing genotype changes in the virus. althoughcovid-19 is known to increase inflammatory markers associated with atrial arrhythmias, the contemporaryliterature has poorly described new onset arrhythmias as a complication in previously healthy neonates withcovid-19.case presentation: a twenty-day-old female term neonate, born by caesarean section withimmediate cry, developed labored breathing, cyanosis, and tachycardia after having close contact with aconfirmed case of covid-19. the neonate developed atrial flutter, which was refractory to cardioversion anddrugs, namely amiodarone, flecainide, and propranolol. the authors treated the neonate with ivig. this isthe first reported case of atrial flutter in the neonatal period secondary to covid-19.conclusion: since the start of the sars-cov-2 pandemic, all attention and concerns have been mainlyon respiratory manifestations and complications. the cardiovascular complications and treatment have beenneglected. this case reports tachyarrhythmia (atrial flutter) as an unusual presentation of acute covid-19in the neonatal population and shows the role of ivig in the treatment of refractory arrhythmias.