An Elderly COVID-19 Pneumonia with Stroke, and QTc Prolongation, Fragmentation of the QRS-complex, and Connected Aircraft Squadron Electrocardiographic Sign (Yasser’s sign); Multiple Risk and Serious Implications

Rationale: COVID-19 infection is a wide-world pandemic serious highly infectious multisystem disease. Neurological, cardiovascular, hepatic, and renal systems are commonly involved. Connected aircraft squadron electrocardiographic sign (Yasser’s sign) is a novel electrocardiographic sign which a relevant to T-wave changes and respiratory rate. This sign is a strong guide for tachypnea. QTc-interval prolongation is a serious signal for torsades de pointes, fatal ventricular tachyarrhythmias, and sudden death. Previously, fragmentation of the QRS-complex had already been considered a marker for structural heart diseases (SHD) triggering cardiac hypertrophy. Patient concerns: An 88-year-old, carpenter, smoker, married Egyptian male patient was admitted to the critical care unit with cerebrovascular stroke, cardiac involvement, and COVID-19 pneumonia. Diagnosis: COVID-19 pneumonia with acute neurological events and cardiovascular involvement. Interventions: Electrocardiography, oxygenation, non-contrasted chest CT, and brain CT. Outcomes: Good response and better outcomes despite the presence of several remarkable risk factors were the results. Lessons: The clinical and electrocardiographic response after using anti-COVID19 measures the signifying its role and suggest the diagnosis of COVID19 infection. The presence of COVID-19 pneumonia, stroke, QTc-interval prolongation, fragmentation of the QRS-complex, hypocalcemia, Connected aircraft squadron electrocardiographic sign (Yasser’s sign) with severe fatigue, elderly, and cigarette smoking are prognostic factors for the severity of the disease.