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First case of COVID-19 complicated with fulminant myocarditis: a case report and insights
Zeng Jia-Hui.
Liu Ying-Xia.
Yuan Jing.
Wang Fu-Xiang.
Wu Wei-Bo.
Li Jin-Xiu.
Wang Li-Fei.
Gao Hong.
Wang Yao.
Dong Chang-Feng.
Li Yi-Jun.
Xie Xiao-Juan.
Feng Cheng.
Liu Lei.
Acceso Abierto
Atribución-NoComercial-SinDerivadas
10.1007/s15010-020-01424-5
BackgroundCoronavirus disease 2019 (COVID-19) has been demonstrated to be the cause of pneumonia. Nevertheless, it has not been reported as the cause of acute myocarditis or fulminant myocarditis.Case presentationA 63-year-old male was admitted with pneumonia and cardiac symptoms. He was genetically confirmed as having COVID-19 according to sputum testing on the day of admission. He also had elevated troponin I (Trop I) level (up to 11.37 g/L) and diffuse myocardial dyskinesia along with a decreased left ventricular ejection fraction (LVEF) on echocardiography. The highest level of interleukin-6 was 272.40 pg/ml. Bedside chest radiographs showed typical ground-glass changes indicative of viral pneumonia. Laboratory test results for viruses that cause myocarditis were all negative. The patient conformed to the diagnostic criteria of the Chinese expert consensus statement for fulminant myocarditis. After receiving antiviral therapy and mechanical life support, Trop I was reduced to 0.10 g/L, and interleukin-6 was reduced to 7.63 pg/mL. Moreover, the LVEF of the patient gradually recovered to 68%. The patient died of aggravation of secondary infection on the 33rd day of hospitalization.ConclusionCOVID-19 patients may develop severe cardiac complications such as myocarditis and heart failure. This is the first report of COVID-19 complicated with fulminant myocarditis. The mechanism of cardiac pathology caused by COVID-19 needs further study.
Infection
2020
Artículo
https://link.springer.com/content/pdf/10.1007/s15010-020-01424-5.pdf
Inglés
VIRUS RESPIRATORIOS
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