Understanding Brugada Pattern in Elderly Patients with COVID-19: A Case Study

Area of Science:

• Cardiology
• Infectious Diseases
• Genetics

Background:

• Brugada syndrome is a hereditary condition causing sudden cardiac death and ventricular arrhythmias.
• Brugada phenocopy presents similar EKG changes but without a hereditary cause.
• SARS-CoV-2 infection is linked to cardiovascular complications, including new-onset arrhythmias and Brugada phenocopy.

Purpose of the Study:

• To report a case of Brugada phenocopy in a nonagenarian with SARS-CoV-2 infection.
• To highlight the association between SARS-CoV-2 and Brugada phenocopy.
• To emphasize the importance of differentiating Brugada phenocopy from Brugada syndrome for appropriate management.

Main Methods:

• Case report of a nonagenarian male with SARS-CoV-2 infection.
• EKG monitoring and clinical presentation assessment.
• Treatment with steroids, remdesivir, and antipyretics.

Main Results:

• The patient presented with chest pain, mild fever, and a Brugada pattern on EKG.
• The Brugada phenocopy resolved following treatment for SARS-CoV-2 infection.
• No implantable cardioverter-defibrillator (ICD) was required, avoiding risks in an elderly patient.

Conclusions:

• Brugada phenocopy can be triggered by infections like SARS-CoV-2 and presents with fluctuating ST elevations.
• Differentiating Brugada phenocopy from Brugada syndrome is critical to guide treatment decisions and avoid unnecessary interventions.
• Prompt management of Brugada phenocopy is essential to prevent malignant arrhythmias and sudden cardiac death.