Florid aortitis following SARS-CoV-2 infection

作者：Simran Shergill, James Davies, James Bloomfield · 发表于：European Heart Journal · 年份：2020 · DOI：10.1093/eurheartj/ehaa635 · 被引用次数：23 · 研究领域：Kawasaki Disease and Coronary Complications、Vasculitis and related conditions、COVID-19 Clinical Research Studies

A 71-year-old male developed symptoms of a dry cough, fever, diarrhoea, and dyspnoea on 15 March 2020. These resolved after 2 weeks, but an altered taste perception persisted. He later experienced extreme fatigue, poor appetite with 5 kg weight loss, and a sharp left-sided chest pain radiating to his scapula. Computed tomography (CT) thorax, abdomen, and pelvis on 15 May demonstrated a diffuse inflammatory aortitis from the subclavian arteries to the iliac bifurcation, without dissection or pseudoaneurysm formation (Panels A and B; Supplementary material online, Video 1). There was no associated rash, jaw claudication, or joint involvement. Examination revealed normal peripheral pulses without radio-radial delay, subclavian or carotid bruits, and non-tender and pulsatile temporal arteries. Blood profile demonstrated a microcytic anaemia with haemoglobin of 77 g/L, C-reactive protein of 185 mg/L, and interleukin-6 of 28 ng/L. Vasculitic autoantibodies were unremarkable, including a negative syphilis serology and immunoglobulin G (IgG) subclass 4. Transthoracic echocardiogram was normal, with no aortic regurgitation or root dilatation. Temporal artery ultrasound demonstrated clear vessels without inflammation. Nasopharygeal swab was negative for SARS-CoV-2 but positive IgG antibody serology proved recent infection. Prednisolone 40 mg was commenced, and surveillance bloods demonstrated resolution of the anaemia and inflammatory indices. The patient’s symptoms resolved, with retu...