Mohamed Sherif, Abo El-Hassan Osama, Rizk Magda, Ismail Jumana H, Baioumy Aml
Chest Diseases and Tuberculosis, Faculty of Medicine, Assiut University, Assiut, EGY.
Pulmonary Medicine, Faculty of Medicine, Cairo University, Cairo, EGY.
Cureus. 2020 Aug 30;12(8):e10127. doi: 10.7759/cureus.10127.
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.
尽管2019年大流行冠状病毒病（COVID-19）的常见临床表现广为人知，但其非典型或罕见表现仍存在问题。此外，尽管已知COVID-19重症的风险因素包括心血管疾病、糖尿病、高血压、慢性肺病和高龄，但仍有年轻患者罹患此病。在此，我们报告一例28岁女性患者，该患者因心脏骤停被送至急诊科，随后在12小时内死亡。最初通过逆转录聚合酶链反应（RT-PCR）进行的拭子检测结果为阴性。然而，她具有COVID-19肺炎的典型CT特征，以及急性肺心病的超声心动图表现。尽管罕见，但心脏骤停可能发生在看似健康的年轻COVID-19患者身上。由于COVID-19患者通常存在凝血障碍、内皮和器官功能障碍、凝血病，且易发生肺血栓栓塞（PTE），因此选择那些PTE风险较高的COVID-19患者并进行CT肺动脉造影（CTPA）以诊断PTE非常重要，尤其是在D-二聚体值显著升高的情况下。
