A 51-year-old woman was admitted with cardiopulmonary arrest. The ECG showed torsade de pointes (Tdp). So, cardio-version and lidocaine administration were carried out and she was successfully resuscitated after 20 min. Serum electrolytes were normal, and she received no QT-prolonging agents. Lung CT scan exhibited bilateral GGO (Figure ) as well as the patient had a positive nasal and oropharyngeal PCR test for COVID-19. The TTE exhibited an LVEF of 35%, normal LV size, increased LV wall thickness (13 mm), no pericardial effusion, no valvular lesion, and no LV thrombus. The patient received IVIG (1 g/kg), 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. So, her hemodynamic status improved after 12 h. Also, angiography displayed a non-significant (<50%) lesion in the middle part of the left anterior descending artery (Figure ). The TTE (after 10 days) revealed a 50% improvement of LVEF with a slight increase in LV wall thickness (11 mm) and the cTnI value had decreased. The patient was discharged in a satisfying condition after 10 days. Follow-up of the patient over 3 months demonstrated an LVEF of 50%.
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.