Infection Care Group, St George's University Hospitals NHS Foundation Trust, London, UK
Infection Care Group, St George's University Hospitals NHS Foundation Trust, London, UK.
BMJ Case Rep. 2021 Feb 23;14(2):e241047. doi: 10.1136/bcr-2020-241047.
We report a case of cardiac injury in a 46-year-old man affected by COVID-19. The patient presented with shortness of breath and fever. ECG revealed sinus tachycardia with ventricular extrasystoles and T-wave inversion in anterior leads. Troponin T and N-terminal pro B-type natriuretic peptide were elevated. Transthoracic echocardiography showed severely reduced systolic function with an estimated left ventricle ejection fraction of 30%. A nasopharingeal swab was positive for SARS-CoV-2. On day 6, 11 days after onset of symptoms, the patient deteriorated clinically with new chest pain and type 1 respiratory failure. Treatment with colchicine 0.5 mg 8-hourly resulted in rapid clinical resolution. This case report highlights how cardiac injury can dominate the clinical picture in COVID-19 infection. The role of colchicine therapy should be further studied to determine its usefulness in reducing myocardial and possibly lung parenchymal inflammatory responses.
我们报告了一例 COVID-19 患者的心脏损伤。该患者表现为呼吸急促和发热。心电图显示窦性心动过速，前导有室性期外收缩和 T 波倒置。肌钙蛋白 T 和 N 末端 pro B 型利钠肽升高。经胸超声心动图显示收缩功能严重降低，左心室射血分数估计为 30%。鼻咽拭子 SARS-CoV-2 检测呈阳性。在症状出现后第 6 天，即第 11 天，患者出现新的胸痛和 1 型呼吸衰竭，临床状况恶化。秋水仙碱 0.5mg，每 8 小时 1 次的治疗导致快速的临床缓解。本病例报告强调了心脏损伤如何在 COVID-19 感染中主导临床表现。秋水仙碱治疗的作用应进一步研究，以确定其在减轻心肌和可能的肺实质炎症反应方面的有效性。
