5. What is known about potential management of arrhythmia syndromes and anti-arrhythmic medications in children?

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5. What is known about potential management of arrhythmia syndromes and anti-arrhythmic medications in children?

SARS-CoV-2 infection may occur in patients with channelopathies e.g. congenital Long QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia and short QT syndrome, with a risk of pro-arrhythmia (4, 29).

In the setting of Long QT syndrome with Covid-19, the QT-interval should be monitored closely because the combination of drugs (hydroxychloroquine and azithromycin) and stress factors (electrolyte disturbances and kidney dysfunction) may further prolong QT (4).

Fever-triggered malignant ventricular arrhythmia is the major concern in Brugada syndrome with Covid-19, therefore fever should be aggressively treated with paracetamol (30).

In patients with catecholaminergic polymorphic ventricular tachycardia and Covid-19, beta-blockers and flecainide should be continued with monitoring of drug interactions with the above-mentioned drugs (4).

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