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. 2020 May 8;4(FI1):1–6. doi: 10.1093/ehjcr/ytaa132
Day(s) of hospita lization Event
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.