Cardiac involvement in cancer patients under chemotherapy and diagnosed with COVID-19: case report and literature review

Pan Afr Med J. 2022 Jan 18:41:45. doi: 10.11604/pamj.2022.41.45.23951. eCollection 2022.

Abstract

Many cases of severe cardiac complications due to Coronavirus disease 2019 (COVID-19) were reported. Cancer and chemotherapy appear to be risk and prognostic factors for COVID-19. A 49-year-old Female, with a history of breast cancer treated by tumorectomy and anthracycline-based chemotherapy was admitted with acute respiratory distress syndrome (ARDS) confirmed as COVID-19. She also had elevated troponin I level (up to 43 g/L), and diffuse myocardial hypokinesia along with severe left ventricle dysfunction on echocardiography. Initial treatment included hydroxychloroquine, azithromycin, corticosteroids and mechanical ventilation. The evolution was marked by QT interval prolongation (QTc=523 ms) and occurrence of cardiogenic shock. The patient died of hemodynamic instability reluctant to resuscitation measures at the 2ndday of hospitalization. COVID-19 patients may develop severe cardiac complications such as myocarditis and heart failure. Receiving chemotherapy especially anthracyclines may be a precipitating and prognostic factor of cardiac manifestations in COVID-19 cancer patients.

Keywords: COVID-19; anthracyclines; cardiac injury; case report; chemotherapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Breast Neoplasms* / complications
  • Breast Neoplasms* / drug therapy
  • COVID-19*
  • Female
  • Heart Diseases* / chemically induced
  • Heart Diseases* / diagnosis
  • Heart Failure* / etiology
  • Humans
  • Middle Aged
  • Shock, Cardiogenic / etiology