Aortitis as a Sequela from COVID-19 Infection

ABSTRACT

Case Diagnosis Aortitis from COVID-19 infection. Case Description or Program Description 74-yearold male with prior MI s/p 2 vessel CAB, and known COVID-19 infection prior to arrival who presented to the local acute care hospital with complaints of worsening shortness of breath and ataxia. He was medically stabilized but found to have continued deficits in selfcare, mobility, and cognition for which he was transferred to an acute inpatient rehabilitation. On his 3rd rehab day he was found to have ongoing fatigue and sustained tachycardia concerning for pulmonary embolism (PE). CT angiogram of the chest revealed no signs of PE, but found evidence suggesting aortitis. Setting(s) Acute Inpatient Rehab Hospital Assessment/Results: Rheumatology was consulted and confirmed aortitis with elevated inflammatory and immunologic markers. He was started the patient on oral prednisone, and had rapid improvement in symptoms in 6 days. He was discharged home with a long-term course of oral steroids and follow up with Rheumatology. Discussion (relevance) We present a rare complication from COVID-19 infection presenting with sustained tachycardia concerning for pulmonary embolism, but found to have aortitis. At the time of diagnosis this was only the third documented case of COVID-19 induced aortitis in the world. Conclusion(s) This case reports a rare and atypical sequela of COVID-19 infection, as it helps illustrate another unique cell-mediated immune response to COVID-19 infection. It highlights the role of a multidisciplinary approach to COVID patients even after the acute infection has resolved.