A 16-year-old boy was admitted with fever, diarrhea, and dry cough that had occurred for 1 week before admission. The first evaluation of the patient at the time of admission was as follows: low blood pressure (80/60 mmHg), non-palpable pulse, and cyanosis, oxygen saturation was 85% without oxygenation, and the body temperature was 38°C. The ECG showed normal sinus rhythm with diffuse anterior ST-segment elevations in precordial leads (Figure ). Rapid improvement of the ECG abnormality resulted from carrying out vasopressors and intubation. Echocardiography represented left ventricular wall thickness, LVEF of 20%–25% with generalized hypokinesis, normal RV size (and function), and dilated inferior vena cava. Moreover, valvular structure and function were normal. The patient had a positive nasal and oropharyngeal PCR test for COVID-19, and the lung CT scan disclosed GGO (Figure ).\nThe patient received IVIG (1 g/kg), broad-spectrum antibiotics (meropenem [500 mg] and doxycycline [200 mg/day]), high-dose corticosteroid (methylprednisolone 1 g/day), and remdesivir for COVID-19. Nonetheless, the patient died the next day after admission due to sudden bradycardia, hypotension, and cardiac arrest.
A 14-year-old girl with a history of glucose-6-phosphate dehydrogenase (G6PD) deficiency was admitted with fever, cough, and dyspnea that had occurred since a week before admission. Moreover, she experienced loss of consciousness that had arisen about an hour before admission. Vital signs were as follows: body temperature = 38.2°C, systolic blood pressure = 60/50 mmHg, heart rate = 145/min, and O2 saturation = 60% without oxygenation. Also, the GCS score was 12. The ECG showed sinus tachycardia and low-voltage limb leads. So, she was intubated immediately, and vasopressors were administered. The chest CT scan showed bilateral diffuse GGO and consolidations (Figure ) as well as she had a positive nasal and oropharyngeal PCR test for COVID-19. Furthermore, the patient was anemic (hemoglobin = 6 g/dl). Echocardiography demonstrated an LVEF of 15%, no pleural effusion, normal inferior vena cava, pulmonary arterial pressure of 30 mmHg, and normal LV and RV size. The patient received broad-spectrum antibiotics (meropenem [500 mg] and doxycycline [200 mg/day]), high-dose corticosteroid (methylprednisolone 1 g/day), and remdesivir for COVID-19. However, the patient died in virtue of acute respiratory distress syndrome (ARDS).