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A Periaortitis Patient Who Succumbed to COVID-19 While Undergoing Systemic Steroid Therapy: A Case Report and

Ammar Abu Baker1, Qusai Aljarrah1, Mohammad Asim Eyadeh1

  • 1Department of General and Vascular Surgery, King Abdullah University Hospital (KAUH), Jordan University of Science and Technology, Irbid, Jordan.

The American Journal of Case Reports
|August 20, 2021
PubMed

Insights

This case report highlights the risks of systemic corticosteroids in patients with periaortitis who contract COVID-19. The study emphasizes the need for updated guidelines on managing steroid-dependent patients with inflammatory aortic conditions during the pandemic.

Area of Science:

  • Cardiovascular Medicine
  • Infectious Diseases
  • Rheumatology

Background:

  • Periaortitis is a rare inflammatory condition affecting the abdominal aorta, typically in middle-aged men.
  • Management strategies for periaortitis patients with COVID-19, particularly regarding steroid therapy, are not well-established.
  • Steroids have anti-inflammatory benefits but also immunosuppressive risks, creating a complex balance in COVID-19 patients.

Observation:

  • A 62-year-old man with autoimmune periaortitis was treated with high-dose corticosteroids (35 mg prednisolone/d).
  • He later developed severe COVID-19 (SARS-CoV-2 infection) with respiratory failure and sepsis.
  • The patient unfortunately died 44 days after readmission to the ICU.

Findings:

  • The case illustrates the potential dangers of maintaining high-dose steroid therapy in periaortitis patients who contract SARS-CoV-2.
  • The immunosuppressive effects of corticosteroids may exacerbate COVID-19 outcomes.

Implications:

  • There is a critical need for international consensus and updated guidelines for managing steroid-dependent patients with inflammatory aortic conditions during COVID-19.
  • Further research and comprehensive analysis of outcomes are essential for these vulnerable patients.

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