AORTOARTERITIS AND SEVERE AORTIC INSUFFI CIENCY IN A PATIENT AFTER COVID-19

Abstract

Aortoarteritis is a rare cause of the aortic insuffi ciency, but it should be considered among the other causes of aortic regurgitation. A number of cases of autoimmune aortoarteritis have been reported during the COVID-19 pandemic. We present a case report of aortoarteritis with severe aortic insuffi ciency, which developed in a patient after a mild form of coronavirus infection and an episode of arthritis. Echocardiography revealed severe aortic regurgitation, dilatation of the thoracic aorta and thickening of the aortic walls. Ultrasonography showed thickening of the carotid arterial walls. Computed tomography confi rmed the diagnosis of aortoarteritis. Elevated C-reactive protein indicated an acute infl ammatory process. Aortoarteritis was treated with methylprednisolone with good clinical response. Possible causes of aortoarteritis are discussed: Takayasu arteritis, giant cell arteritis, ankylosing spondylitis and polychondritis. After exclusion of all possible causes, aortoarteritis in the patient was diagnosed as an autoimmune process caused by coronavirus infection. Cases of arteritis in patients related to COVID-19 are discussed. Multimodality diagnostics (echocardiography, contrast-enhanced computed tomography, ultrasonography of aortic branches) play a central role in detecting aortic lesions and evaluating the extent of the pathological process in aortitis. A laboratory workup is needed to identify the cause of the aortitis. The fi nal diagnosis should be made on the analysis of clinical manifestations, diagnostic and laboratory fi ndings.