COVID 19 with Cardiac Injury Complication, A case Report
Keywords:
COVID-19, coronavirus, cardiac injury, tocilizumab, chest Ct scan.
Abstract
- Background : The Corona virus Disease COVID-19 have been independently associated with the cause of pneumonia and acute respiratory distress syndrome with high risk of mortality. Mounting evidence substantiates the presence of cardiac injury in patients with COVID-19. Although a recent study reported that 12% of patients had COVID-19 associated acute cardiac injury.
- Case presentation : A 38 year old male was admitted with pneumonia and cardiac symptoms. He was genetically confirmed as COVID-19 by swab PCR testing, 1 week after admission. He also had elevated CKMB and Hs troponin T level, high Ferritin level, CRP, lymphopenia, and a slight increase in N/L ratio. Chest radiography showed bilateral pneumonia. The patient was confirmed to the diagnosis of Myocardial injury. After receiving tocilizumab and immunoglobulin, his condition improved gradually with the declining laboratory inflammation marker, but there was a secondary infection with an increased of leucocyte and worsen chest radiography, escalating antibiotic and metilprednisolon was given, the patient gradually improving.
- Conclusion : COVID-19 patients may develop cardiac complication such as cardiac injury or myocarditis, and this is our first case of COVID-19 infection complicated with cardiac injury.
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References
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2. Zeng J, Liu Y. et al. First case of COVID-19 infection with Fulminant Myocarditis Complication : case report and insights. www.preprints.org. Published online March 11, 2020. doi:10.20944/preprints202003.0180.v1
3. Inciardi R, Lupi L, et al. Cardiac Involvement in a Patient With Coronavirus Disease 2019 (COVID-19). JAMA Cardiol. Published online March 27, 2020. doi:10.1001/jamacardio.2020.1096
4. HuangC,WangY,LiX,RenL,ZhaoJ,HuY,ZhangL,FanG,XuJ,GuX,Cheng Z,YuT,XiaJ,WeiY,WuW,XieX,YinW,LiH,LiuM,XiaoY,GaoH,GuoL, Xie J, Wang G, Jiang R, Gao Z, Jin Q, Wang J, Cao B. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395: 497–506.
5. Oudit GY, Kassiri Z, Jiang C, Liu PP, Poutanen SM, Penninger JM et al. SARS-coronavirus modulation of myocardial ACE2 expression and inflammation in patients with SARS. Eur J Clin Invest. 2009;39(7):618-25. doi:10.1111/j.1365-2362.2009.02153.x.
6. XuZ,ShiL,WangY,etal.Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. Published online February 18, 2020. doi:10.1016/S2213-2600 (20)30076-X
7. Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol. 2017;39(5):529- 39. doi:10.1007/s00281-017-0629-x.
8. Luo P, Liu Y,etal, Tocilizumab treatment in COVID-19: A single centre experience. J Med Virol. 2020;1–5. DOI: 10.1002/jmv.25801
9. Cao W, Liu X, etal. High-Dose Intravenous Immunoglobulin as a Therapeutic Option for Deteriorating Patients With Coronavirus Disease 2019. Open Forum Infectious Disease 2020. Doi:10.1093/ofid/ofaa102
Published
2020-05-29
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How to Cite
Saus, P., Hanafy, D., & Barack, R. (2020). COVID 19 with Cardiac Injury Complication, A case Report. Indonesian Journal of Cardiology, 41(2), 49-53. https://doi.org/10.30701/ijc.1011
Section
Case Reports
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