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Introduction
In COVID-19, approximately two third patients may have involvement of cardiovascular system with certain complications such as myocardial injury, myocarditis, acute myocardial infarction, heart failure, dysrhythmias, and venous thromboembolic events [1-3]. Current therapies administered among patients with COVID-19 may also interact with cardiovascular medications [1-3]. This personal paper aims to highlight that cardiovascular complications of COVID-19 such as pre-heart failure (PHF) may be reversed if diagnosed and treated in early stage by appropriate therapy.
Case Report
A 77-year old man presented with COVID-19 as manifestation of side effect of Covishield vaccination because he tested rtPCR positive after the second dose of this vaccine. On the 4th day of vaccination with fever, it was suspected that he may be a case needing investigation, as his fever was persisting. Computerized tomography of thorax revealed that he has cardiomegaly and two thirds of his lungs were destroyed due to lung damage by COVID-19, because his CT score was lower, 12/25.
Biochemical Markers
His blood lymphocytes were 18%/cmm, and his absolute lymphocyte count 0.85, which is below limit, with neutrophils 81%/cmm, Hb 14.2 g/dl. SGOT 48.0 IU/L (normal up to 0-40 IU), and ferritin 385.60 ng/ml. His C-reactive protein (CRP) was 48.10 mg/L (normal, 00.0 to 6 mg/L), D Dimer 348.2 ng/ml (normal <500 ng/ml), IL-6, 4.21 pg/ml (normal 0.0 to 0.5 pg/ml). His LDH was also higher, indicating increased inflammation and cardiac damage (298 IU, normal 225 IU). In view of the clinical and radiological markers, biochemical diagnosis of severe lung damage and mitochondrial damage, he was advised treatment.
After treatment, his CRP was reduced to 7.41 mg/L, indicating decline in inflammation. In view of the suspicion of persistent viremia, he was administered Inj remdesvir 100 mg twice daily, followed by 100 mg daily for four days. He was also administered Inj methyl prednisolone 125 mg infusion thrice daily along with enoxaparin 60 mg daily, carvedilol 3.125 mg daily, and spironolactone daily, for a week.
He was diagnosed with respiratory...