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Post-return of spontaneous circulation (ROSC) management in STEMI patient with COVID-19: a case report

  • Richard ,


Abstract

Background: The COVID-19 pandemic is still a global emergency that causes higher mortality in patients with comorbidities. Current data shows the mortality rate of STEMI patients with COVID-19 is higher than that of STEMI patients without COVID-19. This study aims to improve the knowledge and skills in managing cardiac arrest in COVID-19 patients and post-ROSC management in STEMI patients with COVID-19.

Case Presentation: A 43-year-old man came with a complaint of typical chest pain 3 days before admission, accompanied by symptoms of orthopnea and dyspnea on exercise, and had experienced syncope 3 days prior. History of diabetes mellitus and previous heart attack. The examination results showed tachycardia, tachypnea and oxygen desaturase. The supporting examinations were ESR 89, CRP 48.72, D-dimer: 2.04, and HbA1C 10.1%. Swab Polymerase Chain Reaction (PCR) SARS Cov-2 showed a positive result, with pulmonary edema that may be accompanied by pneumonia (CORADS-3), bilateral pleural effusions, calcification of the descending aorta and coronary arteries LAD, LCX, RCA on computed tomography (CT) imaging. ) Thorax. On bedside echocardiography, EF 28%, LA-LV dilatation, anterior akinetic RWMA, and mild-moderate MR due to functional, mild TR were found. Patients diagnosed with STEMI anterior late onset Killip III, CCS IV, Grace 129, TIMI 9/14; ADHF on ACS; DM, Confirmed Covid-19, Hypoalbuminemia, Hypercoagulation state and had a heart attack and cardiac-respiratory arrest on the 14th day of treatment, performed cardiopulmonary resuscitation (CPR) and entered a state of return of spontaneous circulation (ROSC). The patient continued the treatment until day 23 and was referred to another hospital for further care.

Conclusion: In order to obtain good results in reducing mortality in STEMI patients with COVID-19, it is necessary to have the knowledge and skills of management of cardiac arrest in COVID-19 patients and post ROSC management in STEMI patients with COVID-19, as well as pay attention to and maintaining the safety of the rescuers.

Keywords: cardiac arrest cardiopulmonary resuscitation COVID-19 ROSC SARS-CoV-2
Section

References

  1. Baloch S, Baloch MA, Zheng T, Pei X. The Coronavirus Disease 2019 (COVID-19) Pandemic. Tohoku J Exp Med. 2020;250(4). p271-278. https://doi.org/10.1620/tjem.250.271 .
  2. Yuriditsky E, Mitchell OJL, Brosnahan SB, et al. Clinical characteristics and outcomes of in-hospital cardiac arrest among patients with and without COVID-19. Resusc Plus. 2020;4:100054. https://doi.org/10.1016/j.resplu.2020.100054.
  3. Ginanjar E, Mansjoer A, Rusdi L, et al. Effects of the COVID-19 pandemic on the management of ST-Segment elevation myocardial infarction in Indonesia: a cohort study. F1000Res. 2022;11:629. https://doi.org/10.12688/f1000research.121526.1.
  4. Saad M, Kennedy KF, Imran H, et al. Association Between COVID-19 Diagnosis and In-Hospital Mortality in Patients Hospitalized With ST-Segment Elevation Myocardial Infarction. JAMA. 2021;326(19). p1940-1952. https://doi.org/10.1001/jama.2021.18890.
  5. Vogel B, Claessen BE, Arnold SV, et al. ST-segment elevation myocardial infarction. Nat Rev Dis Primers. 2019;5(1):39. https://doi.org/10.1038/s41572-019-0090-3.
  6. Choudhury T, West NE, El-Omar M. ST elevation myocardial infarction. Clin Med (Lond). 2016;16(3):277-282. https://doi.org/10.7861/clinmedicine.16-3-277.
  7. Mechanic OJ, Gavin M, Grossman SA. Acute Myocardial Infarction. In: StatPearls. Treasure Island (FL): StatPearls Publishing. 2022.
  8. Vernon ST, Coffey S, D'Souza M, et al. ST-Segment-Elevation Myocardial Infarction (STEMI) Patients Without Standard Modifiable Cardiovascular Risk Factors-How Common Are They, and What Are Their Outcomes?. J Am Heart Assoc. 2019;8(21):e013296. https://doi.org/10.1161/JAHA.119.013296.
  9. Tern PJW, Ho AKH, Sultana R, et al. Comparative overview of ST-elevation myocardial infarction epidemiology, demographics, management, and outcomes in five Asia-Pacific countries: a meta-analysis. Eur Heart J Qual Care Clin Outcomes. 2021;7(1). p6-17. https://doi.org/10.1093/ehjqcco/qcaa057.
  10. Harapan H, Itoh N, Yufika A, et al. Coronavirus disease 2019 (COVID-19): A literature review. J Infect Public Health. 2020;13(5):667-673. https://doi.org/10.1016/j.jiph.2020.03.019.
  11. Ganesh B, Rajakumar T, Malathi M, Manikandan N, Nagaraj J, Santhakumar A, Elangovan A, Malik YS. Epidemiology and pathobiology of SARS-CoV-2 (COVID-19) in comparison with SARS, MERS: An updated overview of current knowledge and future perspectives. Clin Epidemiol Glob Health. 2021 Apr-Jun;10:100694. https://doi.org/10.1016/j.cegh.2020.100694.
  12. Baigent C, Andreini D, Windecker S, and Arbelo E. ESC guidance for the diagnosis and management of cardiovascular disease during the COVID-19 pandemic: part 2—care pathways, treatment, and follow-up. European Heart Journal. 2021;43(11). p1-46. https://doi.org/10.1093/eurheartj/ehab697.
  13. Vrachatis DA, Deftereos S, Stefanini GG. STEMI in COVID-19 patients: thrombolysis-first approach could yield more risk than benefit. Eur Heart J. 2020 Nov 7;41(42):4141-4142. https://doi.org/10.1093/eurheartj/ehaa477.
  14. Edelson DP, Sasson C, Chan PS, Atkins DL, Aziz K, Becker LB, et al. Interim Guidance for Basic and Advanced Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19: From the Emergency Cardiovascular Care Committee and Get With The Guidelines-Resuscitation Adult and Pediatric Task Forces of the American Heart Association. Circulation. 2020;141(25). e933-e943. https://doi.org/10.1161/CIRCULATIONAHA.120.047463.
  15. Chojecka D, Pytlos J, Zawadka M, Andruszkiewicz P, Szarpak Ł, Dzieciątkowski T, Jaguszewski MJ, Filipiak KJ, Gąsecka A. How to Maintain Safety and Maximize the Efficacy of Cardiopulmonary Resuscitation in COVID-19 Patients: Insights from the Recent Guidelines. J Clin Med. 2021;10(23). p5667. https://doi.org/10.3390/jcm10235667.
  16. Hsu A, Sasson C, Kudenchuk PJ, Atkins DL, Aziz K, Becker LB, Berg RA, et al. 2021 Interim Guidance to Health Care Providers for Basic and Advanced Cardiac Life Support in Adults, Children, and Neonates With Suspected or Confirmed COVID-19. Circ Cardiovasc Qual Outcomes. 2021;14(10). e008396. https://doi.org/10.1161/CIRCOUTCOMES.121.008396.
  17. DeFilippis EM, Ranard LS, Berg DD. Cardiopulmonary Resuscitation During the COVID-19 Pandemic. Circulation. 2020;141(23). p1833-1835. https://doi.org/10.1161/CIRCULATIONAHA.120.047260.
  18. Brangan K, Day MP. Updated AHA Basic and Advanced Cardiac Life Support guidance with COVID-19 considerations. Nursing. 2022;52(3). p28-33. https://doi.org/10.1097/01.NURSE.0000820020.00324.b0.
  19. Harzand A, Zafari AM. Delayed Intubation During Cardiac Arrest in Covid-19 Patients. International Journal of Critical Care and Emergency Medicine. 2020;6(4). p1-2. https://doi.org/10.23937/2474-3674/1510110.
  20. Kundra P, Vinayagam S. COVID-19 cardiopulmonary resuscitation: Guidelines and modifications. J Anaesthesiol Clin Pharmacol. 2020 Aug;36(Suppl 1):S39-S44. https://doi.org/10.4103/joacp.JOACP_257_20.
  21. Kulkarni AP, Singh Y, Garg H, Jha S. Cardiopulmonary Resuscitation during COVID-19 Pandemic: Outcomes, Risks, and Protective Strategies for the Healthcare Workers and Ethical Considerations. Indian J Crit Care Med. 2020;24(9). p868-872. https://doi.org/10.5005/jp-journals-10071-23544.
  22. Kang Y. Management of post-cardiac arrest syndrome. Acute Crit Care. 2019 Aug;34(3):173-178. https://doi.org/10.4266/acc.2019.00654.
  23. Callaway CW, Donnino MW, Fink EL, Geocadin RG, Golan E, et al. Part 8: Post-Cardiac Arrest Care: 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2015;132(18 Suppl 2). pS465-82. https://doi.org/10.1161/CIR.0000000000000262.
  24. Nolan JP, Sandroni C, Böttiger BW, Cariou A, Cronberg T, Friberg H, et al. European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2021: post-resuscitation care. Intensive Care Med. 2021;47(4). p369-421. https://doi.org/10.1007/s00134-021-06368-4.

How to Cite

Richard. (2023). Post-return of spontaneous circulation (ROSC) management in STEMI patient with COVID-19: a case report. Indonesia Journal of Biomedical Science, 17(1), 107–111. https://doi.org/10.15562/ijbs.v17i1.396
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