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Author Spotlight: Investigating the Pathophysiology of Eosinophilic Esophagitis
Published on: May 10, 2024
Hyepereosiniphilic syndrome and COVID-19: 2 case reports
Alborz Sherafati1, Mehrzad Rahmanian2, Roya Sattarzadeh Badkoubeh1
1Cardiology Department, Imam Khomeini Hospital, Tehran University of Medical Sciences, Keshavarz Boulevard, P.O. Box: 1419733141, Tehran, Iran.
Insights
Hypereosinophilic syndrome (HES) patients with COVID-19 experienced worsened cardiac issues, including heart failure and valve damage. This highlights the critical impact of COVID-19 on HES cardiovascular complications.
Area of Science:
- Cardiology
- Infectious Diseases
- Hematology
Background:
- Hypereosinophilic syndrome (HES) frequently involves cardiovascular complications, a leading cause of mortality.
- COVID-19 infection can exacerbate cardiac involvement in HES patients, negatively affecting prognosis.
Observation:
- Two HES patients with cardiac involvement presented with severe valvular disease (mitral and tricuspid).
- Initial corticosteroid treatment showed partial improvement, but subsequent COVID-19 infection led to disease progression and heart failure exacerbation.
Findings:
- One patient developed severe mitral and tricuspid regurgitation requiring valve replacement after COVID-19 diagnosis.
- The second patient experienced prosthetic valve thrombosis following COVID-19 infection, indicating hypercoagulability.
Implications:
- COVID-19 significantly alters the clinical course of HES, particularly concerning cardiac manifestations.
- Increased risk of myocardial injury, heart failure exacerbation, and thrombosis (native or prosthetic) is associated with COVID-19 in HES patients.
Background:
Nearly half of the patients with hypereosinophilic syndrome (HES) have cardiovascular involvement, a major cause of mortality. COVID-19 infection can lead to cardiac involvement, negatively impacting the clinical course and prognosis. We reported two patients with HES complicated by COVID-19, with cardiac involvement and valve replacement.
Case Presentation:
Our first patient was a 27-year-old woman admitted due to dyspnea and signs of heart failure. She had severe mitral stenosis and mitral regurgitation on the echocardiogram. Corticosteroid therapy improved her symptoms initially, but she deteriorated following a positive COVID-19 test. A repeated echocardiogram showed right ventricular failure, severe mitral regurgitation, and torrential tricuspid regurgitation and, she underwent mitral and tricuspid valve replacement. Our second patient was a 43-year-old man with HES resulted in severe tricuspid stenosis, which was improved with corticosteroid treatment. He underwent tricuspid valve replacement due to severe valvular regurgitation. He was admitted again following tricuspid prosthetic mechanical valve thrombosis. Initial workups revealed lung involvement in favor of COVID-19 infection, and his PCR test was positive.
Conclusion:
COVID-19 infection can change the clinical course of HES. It may result in a heart failure exacerbation due to myocardial injury and an increased risk of thrombosis in prosthetic valves or native vessels due to hypercoagulability.
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