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%.
An 18-year-old woman (with no underlying disease) was admitted with a sudden loss of consciousness, fever, and headache that had occurred for 2 days before admission. At the time of admission, vital signs were as follows: body temperature = 36.8°C, systolic blood pressure = 80/60 mmHg, heart rate = 110/min, and O2 saturation = 80% without oxygenation. Glasgow Coma Scale (GCS) score was 11. She was intubated and treated with vasopressors. Also, rales were heard on pulmonary auscultation. Initial electrocardiogram (ECG) demonstrated sinus tachycardia (110/min) and low voltage QRS. Transthoracic echocardiography (TTE) indicated a small left ventricle (LV) with an end-diastolic dimension of 42 mm, a left ventricular ejection fraction (LVEF) of 10% with global hypokinesis, a normal right ventricle (RV), and pulmonary arterial pressure (PAP), no pericardial effusion (PE) or thrombosis, and no significant valve lesions or dysfunction. Chest computed tomography (CT) scan revealed diffuse bilateral ground-glass opacities (GGO) and basal consolidations (Figure ). Moreover, the patient had a positive nasal and oropharyngeal polymerase chain reaction (PCR) test for COVID-19. Laboratory findings are summarized in Table . The patient received intravenous immunoglobulin (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. However, she died due to cardiac arrest (less than 24 h after admission).