Table 3

Literature review of cases of secondary TC in patients with COVID-19

Case by Minhas et al5Case by
Meyer et al6
Case by Solano-López et al7Case by
Nguyen et al8
Case by
Roca et al9
Case series by Pasqualetto et al10
Patient 1Patient 2Patient 3
Age in years5883507187848581
Presenting symptomsCough, fatigue, fever, diarrhoea for 5 daysChest pain, dry cough and mild dyspnoeaCough, dyspnoea and fever for 8 daysFaintingFever, fatigue, dyspnoeaFever, cough, dyspnoea and atypical chest pain for ~10 days prior to presentation
ComorbiditiesHTN, DM, HLDHTNBenign mediastinal tumour since childhoodHTN
NPH s/p VP shunt
h/o breast cancerHTN, DMHTNHTN, DM
ET intubationYesNoNoYesNoNoYesNo
TroponinNA1142 ng/L (ref <14 ng/L)64 ng/mL412.7 ng/L (ref <14)5318 ng/L (<6)70 ng/mL*647 ng/mL*621 ng/mL*
NT-pro-BNP11.02 ng/mLNA790 pg/mLNANA1381 ng/mL*3000 ng/mL*12586 ng/mL*
CRPNANANANA205.6 (n<5)168.8 mg/L*170.9 mg/L*190.4 mg/L*
D-DimerNANANANANA1381 ng/mL1227 ng/mL3340 ng/mL
ProcalcitoninNANANANANA0.35 ng/mL*3.01 ng/mL*0.07 ng/mL*
ECG1 mm upsloping ST elevation in lead 1 and aVL, diffuse PR depression an ST-T changesDiffuse ST elevation (<1 mm) and T inversions2 mm inferolateral ST elevationSinus rhythm with prolonged QTNegative T waves and repolarisation alterationsDeep T-inversions in all leadsNANA
Variant of TCTypicalTypicalReverseMedianTypicalTypicalUnclear probably typicalTypical
Coronary angiogramNot performedNon-significant lesionsNegativeProximal LAD and D1 significant lesion requiring interventionNot performedNegative†Normal coronary anatomy on autopsyNegative†
In-hospital treatmentDobutamineNANANACeftriaxone, azithromycin, methylprednisoneASA, fondaparinux subcutaneous, nitroglycerin intravenous, metoprolol intravenousASA, clopidogrel, fondaparinux subcutaneous, ionotropic supportASA, fondaparinux subcutaneous, metoprolol intravenous
OutcomeResolution of TC but worsening ARDS‡Near complete recovery of LV function at the time of dischargeImprovement in LV function at the time of dischargeNADischarge homeDischarge homeDeathDischarge home
  • *Peak levels reported.

  • †A coronary angiogram done after resolution of initial COVID-19 pneumonia.

  • ‡Patient in-hospital at the time of publication of the case. The final outcome is unknown.

  • AF, atrial fibrillation; ARDS, acute respiratory distress syndrome; ASA, aspirin; CRP, C reactive protein; D1, first diagonal; DM, diabetes mellitus; EF, ejection fraction; ET, endotracheal; FiO2, fractional inspired oxygen; HLD, hyperlipidaemia; HTN, hypertension; LAD, left anterior descending; LV, left ventricle; NA, not available; NPH s/p VP, normal pressure hydrocephalus status post ventriculoperitoneal shunt; PaO2, arterial oxygen pressure; RVR, rapid ventricular rate; TC, Takotsubo cardiomyopathy; TTE, transthoracic echocardiography.