A clinical case of SARS-CoV-2 infection complicated by viral interstitial pneumonia and pulmonary edema in a patient with dilated cardiomyopathy

Abstract

COVID-19 is especially severe in patients with a premorbid background.Aim: To describe a clinical case of SARS-CoV-2 infection complicated by bilateral viral pneumonia, cardiogenic pulmonary edema, and dilated сardiomyopathy.Clinical case. Patient M.V., 76 years old, from 02.11.2022 to 03.11.2022 was hospitalized at the Republican Cardiological Dispensary with a diagnosis of Bilateral viral pneumonia, the percentage of damage was 75%. Acute respiratory distress syndrome, severe. Complaints at admission: lack of air in a horizontal position, fever up to 38,0 °С, dry cough. Computed tomography of the chest was performed; bilateral viral pneumonia was determined (75% of lesions). PCR smear for coronavirus infection was positive. Determination of troponin T from 02.11.2022: 0.022 ng/ml. History: hypertension for many years with maximum blood pressure of 190/100 mm Hg, acute myocardial infarction of the anterior wall of the left ventricle with ST segment elevation (November 20, 2021), percutaneous coronary intervention (November 20, 2021). The above complaints were noted within a week. On the second day of inpatient treatment, a lethal outcome occurred. She was sent for a post-mortem examination. In the lungs, histological examination revealed a violation of microcirculation in the form of erythrocyte sludge, stasis. Widespread atelectasis/dystelectasis. There was intraalveolar edema. On macroscopic examination, the cavities of the heart are enlarged.Histological examination revealed large-focal cardiosclerosis, areas of wave-like deformation of myocardial muscle fibers. Virological examination of sectional material in the lungs and heart revealed SARS-CoV-2 RNA.Conclusion. Viral infection with COVID-19 contributed to the development of decompensation of chronic heart failure in the form of arrhythmia and cardiogenic pulmonary edema in a patient with dilated cardiomyopathy.