Death due to Cardiac Arrest in a Young Female With Highly Suspected COVID-19: A Case Report.

Sherif Mohamed,Aml Baioumy,Magda Rizk,Jumana H Ismail,Osama Abo El-Hassan

doi:10.7759/cureus.10127

Abstract

Despite the common clinical presentations of the pandemic coronavirus disease of 2019 (COVID-19) being well-known, there remain issues on its atypical or rare presentations. Moreover, despite the known risk factors for severe COVID-19 are cardiovascular disease, diabetes mellitus, hypertension, chronic lung disease, and advanced age, still younger patients suffer from this disease. Herein, we present a case report of a 28-year-old female patient who was presented to the ED with cardiac arrest, then died within 12 hours. First swab testing by reverse transcription-polymerase chain reaction (RT-PCR) came negative. However, she has typical CT features of COVID-19 pneumonia, along with an echocardiographic picture of acute cor pulmonale. Though it is rare, cardiac arrest can happen in young apparently healthy patients with COVID-19. As COVID-19 patients are commonly having clotting disorders, endothelial and organ dysfunction, coagulopathy, and liable for pulmonary thromboembolism (PTE), it is important to select those COVID-19 patients who are at higher risk of PTE, and practice CT pulmonary angiography (CTPA) for the diagnosis of PTE, especially in case of significant increase of D-dimer values.

Highlights

Despite the fact that common classical clinical presentations of the pandemic coronavirus disease of 2019 (COVID-19) are well-known, there remain issues on its atypical or rare presentations
Despite the known risk factors for severe COVID-19 are cardiovascular disease, diabetes mellitus, hypertension, chronic lung disease, and advanced age, still younger patients suffer from this disease
As COVID-19 patients are commonly having clotting disorders, endothelial and organ dysfunction, coagulopathy, and liable for pulmonary thromboembolism (PTE), it is important to select those COVID-19 patients who are at higher risk of PTE, and practice CT pulmonary angiography (CTPA) for the diagnosis of PTE, especially in case of significant increase of D-dimer values

Summary

Introduction

Despite the fact that common classical clinical presentations of the pandemic coronavirus disease of 2019 (COVID-19) are well-known, there remain issues on its atypical or rare presentations. Swab testing by reverse transcription-polymerase chain reaction (RT-PCR) came negative on the day She had typical CT features of COVID-19 pneumonia. COVID-19 pandemic -- the resuscitating team decided to do urgent plain CT of the brain and chest before transferring the patient to the ICU. The treating and ICU teams decided ventilator strategy for acute respiratory distress syndrome (ARDS), prone positioning, IV vasopressors, septic workup, coagulation profile, and to do tracheal secretions swabbing for RT-PCR. Her laboratory workup revealed normal total white blood count (WBC) with relative neutropenia and lymphocytosis, hemoglobin (Hb) level of 11.2 g/dL, and normal platelet count. A consent was obtained from the patient husband for publication of this case report

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