A 34-year-old woman was admitted with complaint of losing consciousness and she had also been suffering from fever and headache for six consecutive days. Vital signs were as follows: body temperature = 36.7°C, systolic blood pressure = 80/60 mmHg, heart rate = 114/min, and O2 saturation = 82% without oxygenation. Also, the GCS score equaled 8. The ECG monitoring revealed ventricular tachycardia (Figure ); so, the direct current (DC) shock was administered and the patient was intubated. Echocardiography showed normal LV and RV size, moderate tricuspid and mitral regurgitation, systolic pulmonary artery pressure of 30 mmHg, and LVEF of 30%. The chest CT scan illustrated bilateral GGO and basal consolidations (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]), high-dose corticosteroid (methylprednisolone 1 g/day), and remdesivir for COVID-19. The patient was discharged after 3 weeks with LVEF of 40%–45% and normal cardiac biomarkers. Follow-up of the patient for 3 months showed an LVEF of 45%–50%.
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).