A 29-Year-Old Man with COVID-19 Pneumonia, Heart Failure-Reduced Ejection Fraction, and Atrial Fibrillation with a Father and 2 Grandparents Who Were Positive for SARS-CoV-2 Infection

Case series Patients: Male, 29-year-old • Male, 54-year-old • Male, 84-year-old • Female, 79-year-old Final Diagnosis: Atrial fibrillation • COVID-19 • heart failure Symptoms: Dyspnea • palpitation Medication: — Clinical Procedure: — Specialty: Cardiology OBJECTIVE: Unusual clinical course BACKGROUND: We report 4 family members, a 29-year-old son, 54-year-old father, 79-year-old grandmother, and 84-year-old grandfather, with COVID-19 pneumonia. Only the son had heart failure, with reduced ejection fraction and atrial fibrillation. This report aims to show that age and baseline comorbidities are not always predictors of severe COVID-19 disease. CASE REPORTS: Case 1: The son, a 29-year-old man, presented with dyspnea and palpitation. His nasopharyngeal swab was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). He required high-flow nasal cannula oxygen therapy and had new-onset atrial fibrillation and reduced ejection fraction. Case 2: The father, a 54-year-old man, presented with dyspnea. Nasopharyngeal swab was positive for SARS-CoV-2. He required regular nasal cannula oxygen therapy. Electrocardiogram showed sinus rhythm. Echocardiogram showed normal ejection fraction. Case 3: The grandfather, an 84-year-old man with a history of atrial flutter, chronic kidney disease, and hypertension, presented with dyspnea and fever. Nasopharyngeal swab was positive for SARS-CoV-2. He required regular nasal cannula oxygen therapy. Electrocardiogram showed sinus rhythm. Echocardiogram showed normal ejection fraction. Case 4: The grandmother, a 79-year-old woman with a history of hypertension, presented with dyspnea. Nasopharyngeal swab was positive for SARS-CoV-2. She required regular nasal cannula oxygen therapy. Electrocardiogram showed sinus rhythm. CONCLUSIONS: COVID-19 caused by SARS-CoV-2 is recognized to affect family members and can involve the heart, causing heart failure and cardiac arrhythmia like atrial fibrillation. This report highlights the importance of cardiac monitoring and consideration of cardiac damage, even without previous risk factors, in all hospitalized patients with COVID-19.