COVID-19 PRESENTING WITH FAILED HEART, CONGESTED LIVER AND PATCHY LUNG IN A YOUNG PATIENT: A CASE REPORT

Dr. C Arshad Akeel; Dr. M Phani Krishna; Dr. Neetu Mariam Alex

Volume : X, Issue : VII, July - 2020

COVID-19 PRESENTING WITH FAILED HEART, CONGESTED LIVER AND PATCHY LUNG IN A YOUNG PATIENT: A CASE REPORT

Dr. C Arshad Akeel, Dr. M Phani Krishna, Dr. Neetu Mariam Alex

Abstract :

Coronavirus disease 2019 (COVID–19) caused by Severe acute respiratory syndrome coronavirus 2 (SARS CoV–2) was declared as a pandemic by world health organisation (W.H.O) on 11th March 2020. SARS CoV–2 enters the host cells by binding with ACE–2 receptors. Studies have shown that apart from lung, ACE– 2 receptors are expressed in many other organs which may explain the non–respiratory symptoms. Apart from thrombotic complications like acute coronary syndrome and venous thromboembolism, a wide range of arrhythmias and myocarditis with acute heart failure were reported in association with COVID–19. We report a young male admitted with complaints of exertional dyspnea for 4 days. He was subsequently diagnosed to have COVID–19 pneumonia and bi–ventricular dysfunction. Any patient presenting with acute heart failure with no history of any comorbidities and cardiovascular disease should be evaluated for COVID–19 in current scenario. Patient should be started on guideline directed medical therapy and expectant management in patients with stable hemodynamics. All the patients should receive anticoagulants to prevent thrombotic complications. ACE inhibitors and ARBs can be continued. Serial inflammatory bio markers monitoring, QTc monitoring and electrolyte monitoring is recommended.