Cardiac arrest and COVID-19: inflammation, angiotensin-converting enzyme 2, and the destabilization of non-significant coronary artery disease—a case report. Issue 1 (12th December 2020)

• Record Type: Journal Article
• Authors: Colombier, Sébastien; Mahendiran, Thabodhan; Niclauss, Lars; Kirsch, Matthias
• Editors: Elad, Asher; Mohamed, Farag; D'Amario, Domenico; Mukherjee, Rahul; Aiste Monika, Jakstaite
• Is Part Of: European heart journal. Volume 5:Issue 1(2021)
• Publication Date: 2020-12-12
• Subjects: COVID-19 -- SARS-CoV-2 -- Cardiac arrest -- Extracorporeal life support -- Case report; Cardiology -- Periodicals; Cardiology -- Case studies -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Case studies -- Periodicals; 616.12
• DOI: 10.1093/ehjcr/ytaa475
• Languages: English
• ISSNs: 2514-2119

Abstract

Abstract: Background: The new β-coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appears to exhibit cardiovascular pathogenicity through use of angiotensin-converting enzyme 2 (ACE2) for cell entry and the development of a major systemic inflammation. Furthermore, cardiovascular comorbidities increase susceptibility to SARS-CoV-2 infection and the development of a severe form of COronaVIrus Disease 2019 (COVID-19). Case summary: We describe the case of a COVID-19 patient whose inaugural presentation was a refractory cardiac arrest secondary to the destabilization of known, non-significant coronary artery disease. Patient was supported by venoarterial extracorporeal life support. After 12 h of support, cardiac function remained stable on low vasopressor support but the patient remained in a coma and brainstem death was diagnosed. Discussion: Myocardial injury is frequently seen among critically unwell COVID-19 patients and increases the risk of mortality. This case illustrates several potential mechanisms that are thought to drive the cardiac complications seen in COVID-19. We present the potential role of inflammation and ACE2 in the pathophysiology of COVID-19.