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Sudden Cardiac Arrest in a Patient With Myxedema Coma and COVID-19.
Dixit, Neal M; Truong, Katie P; Rabadia, Soniya V; Li, David; Srivastava, Pratyaksh K; Mosaferi, Tina; Calfon Press, Marcella A; Donangelo, Ines; Kelesidis, Theodoros.
Afiliación
  • Dixit NM; Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
  • Truong KP; Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
  • Rabadia SV; Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
  • Li D; Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.
  • Srivastava PK; Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, California.
  • Mosaferi T; Division of Endocrinology, David Geffen School of Medicine at UCLA, Los Angeles, California.
  • Calfon Press MA; Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, California.
  • Donangelo I; Division of Endocrinology, David Geffen School of Medicine at UCLA, Los Angeles, California.
  • Kelesidis T; Division of Infectious Diseases, David Geffen School of Medicine at UCLA, Los Angeles, California.
J Endocr Soc ; 4(10): bvaa130, 2020 Oct 01.
Article en En | MEDLINE | ID: mdl-32984743
SARS-CoV-2 infection is associated with significant lung and cardiac morbidity but there is a limited understanding of the endocrine manifestations of coronavirus disease 2019 (COVID-19). Although thyrotoxicosis due to subacute thyroiditis has been reported in COVID-19, it is unknown whether SARS-CoV-2 infection can also lead to decompensated hypothyroidism. We present the first case of myxedema coma (MC) in COVID-19 and we discuss how SARS-CoV-2 may have precipitated multiorgan damage and sudden cardiac arrest in our patient. A 69-year-old woman with a history of small cell lung cancer presented with hypothermia, hypotension, decreased respiratory rate, and a Glasgow Coma Scale score of 5. The patient was intubated and administered vasopressors. Laboratory investigation showed elevated thyrotropin, very low free thyroxine, elevated thyroid peroxidase antibody, and markedly elevated inflammatory markers. SARS-CoV-2 test was positive. Computed tomography showed pulmonary embolism and peripheral ground-glass opacities in the lungs. The patient was diagnosed with myxedema coma with concomitant COVID-19. While treatment with intravenous hydrocortisone and levothyroxine were begun the patient developed a junctional escape rhythm. Eight minutes later, the patient became pulseless and was eventually resuscitated. Echocardiogram following the arrest showed evidence of right heart dysfunction. She died 2 days later of multiorgan failure. This is the first report of SARS-CoV-2 infection with MC. Sudden cardiac arrest likely resulted from the presence of viral pneumonia, cardiac arrhythmia, pulmonary emboli, and MC-all of which were associated with the patient's SARS-CoV-2 infection.
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Texto completo: 1 Banco de datos: MEDLINE Idioma: En Revista: J Endocr Soc Año: 2020 Tipo del documento: Article

Texto completo: 1 Banco de datos: MEDLINE Idioma: En Revista: J Endocr Soc Año: 2020 Tipo del documento: Article