Although coronavirus disease 2019 (COVID-19) primarily manifests pulmonary symptoms, providers are recognizing extrapulmonary symptoms including cutaneous manifestations. Cutaneous manifestations in COVID-19 patients include acroischemic, chilblain-like eruption, petechiae and purpura, vesicles, urticaria, and erythematous maculopapules. 1 Herpes zoster (HZ) is caused by the varicella-zoster virus, which reactivates and spreads from the dorsal root ganglia to its respective dermatome. Patients at risk of HZ include elders and immunocompromised hosts. Although COVID-19 is known to affect the immune system and may increase the risk of HZ, limited reports confirm an association between HZ and COVID-19. 2,3 Here, we present a 70-year-old COVID-19 patient complicated by HZ.

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several cardiovascular complications of COVID-19 have been described in clinical studies. While those with pre-existing cardiovascular disease seem to have worse outcomes, growing evidence suggests that COVID-19 itself can cause myocardial injury, arrhythmia, and heart failure. We report a case of a 27-year-old male with no known comorbidities who presented with nausea, vomiting and non-radiating substernal chest pressure without respiratory symptoms in May of 2020. Laboratory findings showed elevated cardiac biomarkers and electrocardiogram showed diffuse ST-segment elevation. Coronary angiography revealed normal coronaries but findings suggestive of cardiogenic shock. Reverse transcription polymerase chain reaction for SARS-CoV-2 returned positive. He was treated for fulminant myopericarditis and cardiogenic shock with remdesivir, steroid, inotropes and vasopressors but rapidly deteriorated and went into cardiac arrest and was unable to be resuscitated despite multiple rounds of cardiopulmonary resuscitation. Fulminant myopericarditis is a rare complication of COVID-19 with high mortality that requires early recognition, treatment and a transfer to a tertiary facility with advanced cardiac services.

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