Prosthetic aortic valve endocarditis complicated by COVID‐19 and hemorrhage

Abstract

The novel coronavirus, now termed SARS‐CoV‐2, has caused a significant global impact in the space of 4 months. Almost all elective cardiac surgical operations have been postponed with only urgent and emergency operations being considered in order to maximise resource utilisation. We present a case of a 69‐year old lady with an infected prosthetic aortic valve for consideration of urgent inpatient surgery. Despite being asymptomatic and testing negative initially for COVID‐19 RT‐PCR swab, further investigations with CT revealed suspicious findings. She subsequently tested positive on a repeat swab and unfortunately deteriorated rapidly with complications including gastro‐intestinal and intracerebral haemorrhage.

COVID-19 and Cerebrovascular Diseases: A Systematic Review and Perspectives for Stroke Management

“…Acute intracranial bleeding was reported in 35 patients with COVID-19 in the literature ( Table 2, Supplementary Table 2): 24 patients (68.57%) had intracerebral hemorrhage (ICH), 4 patients (11.43%) had non-traumatic subarachnoid hemorrhage (SAH), and the remaining 7 patients (20%) had the simultaneous presence of SAH and ICH. The mean age of the 35 patients with intracranial bleedings was 59.89 ± 11.91 years and 67.4% were males (16,25,28,64,71,73,(107)(108)(109)(110)(111)(112)(113)(114)(115)(116)(117)(118)(119)(120)(121). Two of the 11 patients with non-traumatic SAH (regardless of the presence of ICH) were found to have a ruptured dissecting aneurysm (one in the posterior inferior cerebellar artery; one in the pericallosal artery).…”

Incidence of infective endocarditis during the coronavirus disease 2019 pandemic: A nationwide study

“…Reorganization of the healthcare system including postponing elective cardiac surgeries may impact patients with IE, as reported in a recent case report by Hussain et al on an IE case complicated by COVID-19 and severe hemorrhages [28] . Further studies are needed in order to enlighten the course of concomitant IE and COVID-19 infection.…”

Septic Embolism in a Patient with Infective Endocarditis and COVID-19

“…Camila Negreiro Dias, 1 Luís Arthur Brasil Gadelha Farias, 2,3 * and Francisco Juliao Moreira Barreto Cavalcante 1 1 Hospital Universitário Walter Cantídeo (HUWC), Fortaleza, Brazil; 2 Hospital São José de Doenças Infecciosas (HSJ), Fortaleza, Brazil;…”

“…Other similar cases have been reported, although this association remains poorly understood. 2 The reported case presented multiple findings of embolic phenomenon. Some studies have suggested that COVID‐19 could also manifest in significant abnormal coagulation parameters, and clinically as vessel thrombosis, with patients being frequently anticoagulated.…”

“…Currently, there are few reported cases of infective endocarditis (IE) and COVID-19 infection. 1 , 2 Amir et al 1 reported the first case of COVID-19 management in a patient with concomitant IE. Other similar cases have been reported, although this association remains poorly understood.…”