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First case of COVID-19 complicated with fulminant myocarditis: a case report and insights

Jia-Hui Zeng1, Ying-Xia Liu2, Jing Yuan3

  • 1Department of Medical Ultrasonics, National Clinical Research Center for Infectious Disease, State Key Discipline of Infectious Disease, Shenzhen Third People's Hospital, Second Hospital Affiliated to Southern University of Science and Technology, No. 29 Bulan Road, Shenzhen, 518112, People's Republic of China.

Infection
|April 12, 2020
PubMed

Insights

This case report details the first instance of Coronavirus disease 2019 (COVID-19) complicated by fulminant myocarditis. The patient experienced severe cardiac symptoms, but treatment led to recovery of heart function, though they later succumbed to secondary infection.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) is a known cause of pneumonia.
  • Cardiac complications, including acute or fulminant myocarditis, have not been previously reported in COVID-19 patients.

Observation:

  • A 63-year-old male with COVID-19 presented with pneumonia and cardiac symptoms, including elevated troponin I and reduced left ventricular ejection fraction (LVEF).
  • Diagnostic tests ruled out other common causes of myocarditis.
  • The patient met the criteria for fulminant myocarditis.

Findings:

  • Treatment with antiviral therapy and mechanical support improved cardiac function, with troponin I and interleukin-6 levels decreasing and LVEF recovering.
  • Despite initial cardiac recovery, the patient died due to a secondary infection.

Implications:

  • COVID-19 can lead to severe cardiac complications, including myocarditis and heart failure.
  • This case highlights the potential for severe cardiac involvement in COVID-19.
  • Further research is needed to understand the mechanisms of COVID-19-induced cardiac pathology.
Abstract

Keywords:
COVID-19CoronavirusEchocardiographyFulminant myocarditisInfection

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