This case report highlights the potential for transient cardiomyopathy with negative cardiac biomarkers in severe COVID-19 and its rapid improvement following tocilizumab therapy.
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Reports atypical COVID-19 cardiomyopathy with negative biomarkers; extends phenotypic spectrum but remains hypothesis-generating.
BACKGROUND: Cardiac manifestations during Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) pandemic have included acute coronary syndrome, arrhythmias, myocarditis, and stress cardiomyopathy. However, the combination of cardiomyopathy and negative cardiac biomarkers has not yet been reported. CASE SUMMARY: A 49-year-old man admitted for respiratory failure secondary to SARS-CoV-2 developed new-onset cardiomyopathy with negative cardiac biomarkers. Left ventricular ejection fraction and strain improved 7 days after the initial echocardiogram, after administration of Tocilizumab, coinciding with clinical recovery, and improvement in inflammatory markers. DISCUSSION: As experience of cardiovascular manifestations of SARS-CoV-2 increases, more patients will likely present with cardiovascular manifestations; the recognition and proper management of these may improve patient outcomes.
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Tarun et al. (2020) studied this question.
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