Novel Behavior of the 2019 Novel Coronavirus With Invasion of the Cardiac Conduction System in the Young

Abstract

We report the case of a 35-year-old man (an oil engineer) referred as a coronavirus disease-2019 (COVID-19) case with heart block and a four-day history of headache and fever. The patient was hemodynamically stable with normal respiratory effort and oxygen saturation. Three consecutive COVID-19 tests were positive since admission. Comprehensive clinical assessment investigations were performed. Apart from mild acute phase reactants elevation, all results were within reference limits. He had no leukocytosis and normal cardiac enzymes, chest x-ray findings, echocardiography findings, and healthy coronary arteries. The patient had a fever and electrocardiographic evidence of sinus node dysfunction associated with Mobitz type 2 atrioventricular block that progressed to complete heart block. This was a unique presentation of COVID-19 in a young, otherwise healthy man with the sole manifestation confined to the cardiac conduction system and the absence of respiratory involvement, hypoxemia, and acidosis.

Keywords: complete heart block; covid-19 and heart; permanent pacemaker implantation (ppm).