Patient 1 |
|
0 |
Patient presents with 10 days of fever, congestion, and dry cough. COVID-19 is diagnosed. |
1 |
Intubated for acute hypoxic respiratory failure. |
2 |
Patient develops new sinus bradycardia (rate 38 b.p.m.) with decrease in mean arterial blood pressure (MAP) to a nadir of 50 mmHg. |
Transthoracic echocardiogram does not demonstrate any structural or functional abnormalities. Epinephrine infusion is started with improvement of MAP to 65 mmHg. |
Sedation is changed from propofol to midazolam without improvement in heart rate. |
3 |
Epinephrine is weaned but the patient becomes hypotensive and does not have a compensatory rise in heart rate. |
Midazolam is changed to ketamine with improvement in MAP. Epinephrine is discontinued. |
4–15 |
Patient remains haemodynamically stable in sinus bradycardia. |
16 |
Patient is extubated and remains in sinus bradycardia. |
Patient 2 |
|
0 |
Patient presents with 7 days of fever, cough, and congestion after recent travel. COVID-19 is diagnosed.Intubated for acute hypoxic respiratory failure |
4 |
Patient develops new sinus bradycardia (rate 51 b.p.m.) but remains haemodynamically stable. |
Transthoracic echocardiogram does not demonstrate any structural or functional abnormalities. |
Sedation is changed from propofol to ketamine without improvement in heart rate. |
6 |
Patient develops numerous episodes of accelerated idioventricular rhythm with associated hypotension; however, he does not require initiation of vasopressors due to prompt conversion to haemodynamically stable sinus rhythm. |
7–14 |
Patient continues to be in haemodynamically stable sinus bradycardia with intermittent episodes of accelerated idioventricular rhythm. |
15 |
Patient is extubated and remains in stable sinus bradycardia. |