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 22-year-old man (with no history of underlying disease) was admitted with dry cough and dyspnea that had developed for 5 days before admission. Vital signs were as follows: body temperature = 36.8°C, systolic blood pressure = 70/50 mmHg, heart rate = 120/min, and O2 saturation = 90% without oxygenation. The ECG showed sinus tachycardia. The patient had a positive nasal and oropharyngeal PCR test for COVID-19, and pulmonary edema was observed by CT scan (Figure ). Echocardiography showed LVEF of 30%–35%, left ventricular end-diastolic diameter of 5 cm, moderate RV enlargement and dysfunction, dilated inferior vena cava, and mild left-sided pleural effusion. The patient received broad-spectrum antibiotics (meropenem [500 mg q8 h for 5 days] and doxycycline [200 mg/day]), high-dose corticosteroid (methylprednisolone 1 g/day), and remdesivir for COVID-19. The patient was discharged after 7 days with stable hemodynamics. Follow-up of the patient for 3 months showed an LVEF of 45% and a normal cTnI value.