J-wave in a patient with severe COVID-19

In the context of the current COVID-19 epidemic, numerous are the manifestations of the infected patients, including the alterations in the 12-lead electrocardiogram, where the presence ofa J-wave can be found, secondary to the generation ofa transmural voltage gradient, caused by the overexpression of the channels for transient outward potassium current (Ito), in the context of a severe infection with extensive myocardial injury. In this article is presented the case of an 83-year-old patient with a positive diagnosis of COVID-19, who progressed to septic shock, with mixed addosis and mild hyperkalemia. The electrocardiogram showed the presence of a Jwave, probably secondary to the effect ofpro-inflammatory cytokines on potassium channels and extensive areas of myocardial injury.

Brugada phenocopy in the context of a severe COVID-19 infection

Brugada phenocopies are an electrocardiographic pattern with the same morphologhy as the Brugada Synrome type 1 and 2 pattern, in patients with metabolic, ischemic and/or mechanical alterations. This is a 74-year-old patient with a history of Arterial Hypertension, who is admitted to the Intensive Care Unit with a positive diagnosis of COVID-19. He presents mixed acidosis, severe hypoxemia and hyperkalemia and in twelve-lead electrocardiogram a Brugada type 1 pattern (coved). Metabolic disorders, myocardial damage, and ventilation/perfusion alterations in the context of a seriuos infection due to COVID-19 would be the mechanisms responsible for this electrocardiographic pattern in these patient. © 2021, Cuban Society of Cardiology, Cuban Institute of Cardiology and Cardiovascular Surgery. All rights reserved.