The COVID-19 pandemic caused by the SARS-CoV-2 virus presents new diagnostic challenges including differentiating COVID-19 infection from other diagnostic entities. Both COVID-19 infection and acute endocarditis may present with hypoxic respiratory failure, fever, and elevated inflammatory biomarkers. The task of distinguishing the two is complicated by the complexities of interpreting SARS-CoV-2 RT-PCR test results. The RT-PCR test may be negative early in the disease course 1-3 and may remain positive long after the initial infection due to viral clearance delay. 4,5 Here, we present two cases of left-sided endocarditis, which were both initially attributed to COVID-19 infection, and only correctly diagnosed after echocardiography was performed.

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