A 28-year-old man was admitted with chest pain, fever, and dry cough that had arisen for 3 days before admission. Vital signs were as follows: body temperature = 36.8°C, systolic blood pressure = 100/60 mmHg, heart rate = 92/min, and O2 saturation = 92% without oxygenation. The ECG illustrated sinus rhythm with ST-segment elevation and Q waves in precordial leads. Also, angiography showed normal coronary arteries. Echocardiography revealed LVEF = 30%–35%, hypokinesis in the anterior wall, normal LV size as well as normal RV size and function. Lung CT scan showed a bilateral GGO pattern (Figure ) as well as the patient had a positive nasal and oropharyngeal PCR test for COVID-19. The patient received broad-spectrum antibiotics (meropenem [500 mg q8 h for 5 days] and doxycycline [200 mg/day]), corticosteroid (methylprednisolone 1 mg/kg/day), and remdesivir for COVID-19 for 7 days. It is worth mentioning that LVEF improved to 45%–50% after treatment. He recovered within 3 days and was discharged in a satisfying condition. Follow-up of the patient for 3 months revealed LVEF of 45%–50% and a normal cardiac function.
A 45-year-old man was admitted with a fever that lasted for 2 weeks, dyspnea, and pleuritic chest pain continued for 1 week. Vital signs were as follows: body temperature = 38.5°C, systolic blood pressure = 100/70 mmHg, heart rate = 90/min and, O2 saturation = 85% without oxygenation (90% with nasal oxygen therapy). The ECG showed sinus tachycardia, no significant changes in the ST-segment, low-voltage waves in the limb leads, and QRS alternans. The TTE revealed LVEF of 45%, normal LV size and function without regional wall motion abnormalities, and circumferential pericardial effusion without significant respiratory changes in the mitral and tricuspid valves (Figure ). Lung CT scan showed bilateral GGO suggestive of viral pneumonia (Figure ) as well as the patient had a positive nasal and oropharyngeal PCR test for COVID-19. The patient received broad-spectrum antibiotics (meropenem [500 mg q8 h for 5 days] and doxycycline [200 mg/day]), corticosteroid (methylprednisolone 1 mg/kg/day), and remdesivir for COVID-19. However, the pericardial effusion was resolved by the third day after admission. Oxygen saturation increased to 95% after 5 days (without supplemental oxygen) and he was discharged in a satisfying condition. Follow-up of the patient for 3 months showed an LVEF of 45%, mild pericardial effusion, and normal right ventricular size and function.