Brugada-like ECG Pattern in COVID-19 Infection

• Main Authors: Amir Tavoosi, Mehrangiz Zangeneh, Mansoor Mohsen Abadi, Mahin Nomali, Kian Alipasandi
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2020-11-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: corona virus disease-2019; electrocardiography; fever; hydroxychloroquine; sinus tachycardia
• Online Access: https://jcdr.net/articles/PDF/14273/46477_CE[Ra1]_F(KM)_PF1(AKA_KM)_PN(SL).pdf
• ISSN: 2249-782X; 0973-709X

The Brugada-like ECG pattern is a transient condition which may be induced by number of conditions. In this case reported, a 53-year-old Iranian male patient, presented with 7-day history of fever, chills, headache and shortness of breath. At the time of presentation to the Emergency Department (ED), the patient was febrile with tachycardia, tachypnea, and oxygen (O2 ) saturation 75%. The chest radiograph showed a bilateral infiltration and positive result of Real Time Polymerase Chain Reaction (RTPCR) confirmed the diagnosis of COVID-19 infection. He received Kaletra, Hydroxychloroquine, Azithromycin, Antibiotics, and Intravenous Immunoglobulin (IVIG). The patients was intubated and underwent mechanical ventilation because of no improvement on the O2 saturation level. Fever subsided on 7th day and Hydroxychloroquine was stopped on 5th day. On the sixth day of hospital stay, Electrocardiogram (ECG) showed sinus tachycardia. Troponin-I- high sensitive was within normal range and Transthoracic Echocardiography (TTE) showed normal Ejection Fraction (EF). On 10th day, type I Brugada ECG pattern presented and regular ECG monitoring was recommended. Finally, after eleven-day hospital stay, the patient died due to bradycardia and asystole despite Cardiopulmonary Resuscitation (CPR). Thus, physicians should consider Brugada ECG pattern in the precordial leads (V1 to V3) of ECG among patients with COVID-19 infection beside regular QT interval monitoring.