Peripartum cardiomyopathy mimicking COVID-19 infection

Abstract

A pregnant patient presented with fever and desaturation, without breathlessness. She was suspected to have COVID-19 but SARS-CoV-2 was negative. She developed fetal distress and underwent an uneventful Cesarean section. Postoperatively, she developed respiratory distress and needed mechanical ventilation support. The clinical features suggested COVID-19 infection and antiviral treatment were empirically initiated. Repeat SARS-CoV-2 was negative. Echocardiography, computed tomography scans, and biochemical investigations supported a diagnosis of peripartum cardiomyopathy. She was successfully managed with decongestive therapy and could be discharged home on the fifth day. Garg Shaloo 1 Max Smart Super-Specialty Hospital, Saket, New Delhi Singh Archana 2 Max Smart Super-Specialty Hospital, Saket, New Delhi Kalita Mukesh 3 Max Smart Super-Specialty Hospital, Saket, New Delhi Siddiqui Ayesha 4 Max Smart Super-Specialty Hospital, Saket, New Delhi Kapoor Mukul 5 Max Smart Super-Specialty Hospital, Saket, New Delhi Buekens P, Alger J, Bréart G, Cafferata ML, Harville E, Tomasso G. A call for action for COVID-19 surveillance and research during pregnancy. Lancet Glob Health 2020. doi: S2214-109X(20)30206-0. Luo Y, Yin K. Management of pregnant women infected with COVID-19. Lancet Infect Dis 2020;20:513-4. Yu N, Li W, Kang Q, Xiong Z, Wang S, Lin X, et al. Clinical features and obstetric and neonatal outcomes of pregnant patients with COVID-19 in Wuhan, China: Aretrospective, single-centre, descriptive study. Lancet Infect Dis 2020;20:559-64. Gattinoni L, Chiumello D, Caironi P, Busana M, Romitti F, Brazzi L, et al. COVID-19 pneumonia: Different respiratory treatments for different phenotypes? Intensive Care Med 2020;14:1-4. Pan F, Ye T, Sun P, Gui S, Liang B, Li L, et al. Time course of lung changes on chest CT during recovery from 2019 novel coronavirus (COVID-19) pneumonia. Radiology 2020;295:715-21. Guo T, Fan Y, Chen M, Wu X, Zhang L, He T, et al. Cardiovascular implications of fatal outcomes of patients with coronavirus disease 2019 (COVID-19). JAMA Cardiol 2020;e201017. O'Donnell DH, Abbara S, Chaithiraphan V, Yared K, Killen RP, Martos R, et al. Cardiac MR Imaging of nonischemic cardiomyopathies: imaging protocols and spectra of appearances. Radiology. 2012;262:403-22.