COVID19 INFECTION IN CORONARY ARTERY DISEASE WITH DIABETES AND HYPERTENSION IN VALVULAR SURGERY PATIENTS IN TERTIARY HEART CENTRE

ABSTRACT

Objective: The patient was a 59-year-old man who was referred to the hospital due to shortness of breath due to increased activity, accompanied by cough, weakness, and lethargy. The patient also had a history of diabetes, hypertension, hyperlipidemia, and asthma. The patient also underwent cardiac stenting last year. LCX and LAD stenting Design and method: He had a continuous pan-systolic murmur on cardiac examination diagnosed with valvular dysfunction. Severe aortic regurgitation was reported on echo. The patient underwent a CT scan of the lungs and a PCR test to rule out Covid-19, which was negative. Finally, the patient was diagnosed with severe aortic regurgitation and underwent aortic valve replacement surgery. Echocardiography was performed before the operation, and the diagnosis was confirmed. Results: Echocardiography was performed postoperatively, which showed good valve function and no valve leakage. From the 5th day after the operation, the patient developed fever and increased leukocytosis. Suspected of having Covid19 and accordingly underwent PCR test, the test result was positive;the patient underwent a CT scan of the lungs. After that, he was transferred to the corona ICU. The patient was treated with Remdesivir, and after two weeks, his PCR was negative, and he was almost ready to be discharged. The patient had completed the entire course of treatment and developed pulmonary fibrosis due to Covid disease, but suddenly, after two weeks from the onset of the illness, she developed severe shortness of breath, which led to intubation. We find severe pulmonary fibrosis in the re-CT scan, especially in the left lung, where the entire left lung had fibrosis. Prednisolone was started at a dose of 50 mg three times a day. The patient was intubated for ten days, then gradually removed from the device. Now the patient is extubated and ready for discharge. Conclusions: Risk factors such as Past cardiac surgery and present cardiac intervention with diabetes mellitus increase the risk of developing lung failure in these Covid19 patients. Elective intubation is better than emergency intubation in patients with comorbidities. Corticosteroids can be effective in treating pulmonary insufficiency.