COVID-19 Pneumonia with Flask-shape Cardiomegaly and Bilateral Pleural Effusion; Good Outcome and Possible Differentiation

Rationale: Cardiovascular complications represent a serious outcome of acute coronavirus disease 2019. Cardiomegaly has multiple directories in COVID-19 patients. However, the acute cardiovascular findings post-COVID-19 can make a patient more likely to become severely ill. New-onset cardiac deterioration is frequent in worsen respiratory COVID-19 cases especially, with preexisting cardiac ailments. Pleural effusion is a common pathological accumulation of fluid in the pleural space. Pleural effusion happened in10.3% of COVID-19 patients. Patient concerns: An elder, housewife, widow female, Egyptian patient was presented to the intensive care unit with fever, tachycardia, tachypnea, chest pain, and acute confusion state. She was previously diagnosed as a hypertensive patient. Diagnosis: COVID Pneumonia with bilateral pleural effusion, and huge flask-shape cardiomegaly. Interventions: Chest CT, brain CT, electrocardiography, and oxygenation. Outcomes: Gradual response and good outcomes in the presence of several significant serious risk factors were the results. Lessons: COVID-19 infection may be a predisposing risk factor for cardiac status deteriorations in underlying cardiovascular disease. The association of COVID-19 pneumonia, hypertension, multiple valvular diseases, and bilateral pleural effusion with huge cardiomegaly in an elderly female patient is a constellation of serious risk factors.