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 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).