Brugada-like ECG Pattern in COVID-19 Infection OD06-OD08
Resident of Cardiology, Department of Cardiology, North Kargar St., Tehran Heart Center, Tehran, Iran.
The Brugada-like Electrocardiogram (ECG) pattern is a transient condition which may be induced by number of conditions. In this case reported, a 53-year-old Iranian male patient, presented with seven-day history of fever, chills, headache and shortness of breath. At the time of presentation to the Emergency Department (ED), the patient was febrile with tachycardia, tachypnea, and oxygen (O2 ) saturation 75%. The chest radiograph showed a bilateral infiltration and positive result of Real Time Polymerase Chain Reaction (RT-PCR) confirmed the diagnosis of COVID-19 infection. He received kaletra, hydroxychloroquine, azithromycin, antibiotics, and Intravenous Immunoglobulin (IVIG). The patients was intubated and underwent mechanical ventilation because of no improvement on the O2 saturation level. Fever subsided on seventh day and hydroxychloroquine was stopped on fifth day. On the sixth day of hospital stay, ECG showed sinus tachycardia. Troponin-I- high sensitive was within normal range and Transthoracic Echocardiography (TTE) showed normal Ejection Fraction (EF). On 10th day, type I Brugada-ECG pattern presented and regular ECG monitoring was recommended. Finally, after 11-day hospital stay, the patient died due to bradycardia and asystole despite Cardiopulmonary Resuscitation (CPR). Thus, physicians should consider Brugada-ECG pattern in the pre-cordial leads (V1 to V3) of ECG among patients with COVID-19 infection beside regular QT interval monitoring.