COVID-19 Induced Cardiomyopathy Successfully Treated with Tocilizumab
Background. Currently, the literature regarding the management of COVID-19 induced cardiomyopathy with reduced ejection fraction is limited. In this case report, we present the first documented case of COVID-19 induced myocardial stunning leading to severely reduced LV systolic function that was rev...
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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Case Reports in Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2022/9943937 |
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| author | Ariyon Schreiber Kalaimani Elango Christoph Sossou Sadaf Fakhra Shabada Asad Chowdhury Ahsan |
| author_facet | Ariyon Schreiber Kalaimani Elango Christoph Sossou Sadaf Fakhra Shabada Asad Chowdhury Ahsan |
| author_sort | Ariyon Schreiber |
| collection | DOAJ |
| description | Background. Currently, the literature regarding the management of COVID-19 induced cardiomyopathy with reduced ejection fraction is limited. In this case report, we present the first documented case of COVID-19 induced myocardial stunning leading to severely reduced LV systolic function that was reversed by the administration of corticosteroids and tocilizumab. Case Summary. A 39-year-old female with well controlled systemic hypertension, tested positive for SARS-CoV-2 RNA and underwent self-isolation for 14 days. Patient presented to our facility a month later with one-week history of progressively worsening generalized body aches, chills, fever, watery diarrhea, nausea with associated mild dry nonproductive cough, shortness of breath and nonspecific chest pain. Initial labs demonstrated that she was COVID-19 positive, elevated troponin (4.295 ng/ml), and elevated BNP (2,291 pg/ml). Her initial Transthoracic echocardiography demonstrated an Left ventricular ejection fraction (LVEF) of 20-25% with apical akinesis. After administration of tocilizumab and corticosteroids, patient demonstrated interval improvement with LVEF improving to 50-55% within days. Her labs confirmed these findings with improved troponin (0.858 ng/ml) and BNP (209 pg/ml). Discussion. This case demonstrates that it can be safe and efficacious to use tocilizumab and corticosteroids in patients with COVID-19 induced cardiomyopathy. These finding suggest that cytokine storm is the predominant mechanism by which COVID-19 induced cardiomyopathy occurs. Additional studies are required to determine the role of corticosteroids and tocilizumab in management of this condition. |
| format | Article |
| id | doaj-art-fcad8dd0e8f54e468c410938feeacd51 |
| institution | Kabale University |
| issn | 2090-6412 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Cardiology |
| spelling | doaj-art-fcad8dd0e8f54e468c410938feeacd512025-02-03T05:53:49ZengWileyCase Reports in Cardiology2090-64122022-01-01202210.1155/2022/9943937COVID-19 Induced Cardiomyopathy Successfully Treated with TocilizumabAriyon Schreiber0Kalaimani Elango1Christoph Sossou2Sadaf Fakhra3Shabada Asad4Chowdhury Ahsan5Department of Cardiology-University of NevadaDepartment of Cardiology-University of NevadaDepartment of Cardiology-University of NevadaDepartment of Internal Medicine-University of NevadaDepartment of Infectious Disease-University of NevadaDepartment of Cardiology-University of NevadaBackground. Currently, the literature regarding the management of COVID-19 induced cardiomyopathy with reduced ejection fraction is limited. In this case report, we present the first documented case of COVID-19 induced myocardial stunning leading to severely reduced LV systolic function that was reversed by the administration of corticosteroids and tocilizumab. Case Summary. A 39-year-old female with well controlled systemic hypertension, tested positive for SARS-CoV-2 RNA and underwent self-isolation for 14 days. Patient presented to our facility a month later with one-week history of progressively worsening generalized body aches, chills, fever, watery diarrhea, nausea with associated mild dry nonproductive cough, shortness of breath and nonspecific chest pain. Initial labs demonstrated that she was COVID-19 positive, elevated troponin (4.295 ng/ml), and elevated BNP (2,291 pg/ml). Her initial Transthoracic echocardiography demonstrated an Left ventricular ejection fraction (LVEF) of 20-25% with apical akinesis. After administration of tocilizumab and corticosteroids, patient demonstrated interval improvement with LVEF improving to 50-55% within days. Her labs confirmed these findings with improved troponin (0.858 ng/ml) and BNP (209 pg/ml). Discussion. This case demonstrates that it can be safe and efficacious to use tocilizumab and corticosteroids in patients with COVID-19 induced cardiomyopathy. These finding suggest that cytokine storm is the predominant mechanism by which COVID-19 induced cardiomyopathy occurs. Additional studies are required to determine the role of corticosteroids and tocilizumab in management of this condition.http://dx.doi.org/10.1155/2022/9943937 |
| spellingShingle | Ariyon Schreiber Kalaimani Elango Christoph Sossou Sadaf Fakhra Shabada Asad Chowdhury Ahsan COVID-19 Induced Cardiomyopathy Successfully Treated with Tocilizumab Case Reports in Cardiology |
| title | COVID-19 Induced Cardiomyopathy Successfully Treated with Tocilizumab |
| title_full | COVID-19 Induced Cardiomyopathy Successfully Treated with Tocilizumab |
| title_fullStr | COVID-19 Induced Cardiomyopathy Successfully Treated with Tocilizumab |
| title_full_unstemmed | COVID-19 Induced Cardiomyopathy Successfully Treated with Tocilizumab |
| title_short | COVID-19 Induced Cardiomyopathy Successfully Treated with Tocilizumab |
| title_sort | covid 19 induced cardiomyopathy successfully treated with tocilizumab |
| url | http://dx.doi.org/10.1155/2022/9943937 |
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