COVID-19 can cause myocarditis with complex possible pathophysiology. A case of acute myocarditis in an HIV-infected patient with COVID-19 has been reported here. The patient’s condition progressively improved after proper treatment. But still we have to observe many different cases to get the full picture of COVID-19 in HIV-coinfected people.
We report a case of acute myocarditisin an HIV-infected patient with COVID-19. In the Emergency Department, the patient had a positive nasopharyngeal swab for SARS-CoV-2; pO2 was 66 mmHg and pCO2 36 mmHg. White blood cells(13,000/ µL; N 9,000; L2,200), CRP (108 mg/dL), LDH (336 IU/L) and creatinine (175 µmol/L) were increased. A chest X-ray was apparently normal, while an electrocardiogram showed atrial premature complexes, diffuse inverted T waves in lateral leads, and prolonged QT interval. Troponin levels were 52, 516 and 1,583 ng/L (normal<14 ng/L) at three successive tests, and an echocardiogram showed left ventricular hypertrophy. Myocarditis and pericarditis were diagnosed [1,2]. The patient was admitted to the Intensive Care Unit and treated with enoxaparine 6,000 IUbid, acetylsalicylic acid 250 mg asloading dose, prednisone 25 mg, doxazosin 4 mg, amlodipine 10 mg and hydroxychloroquine 400 mg bid as loading dose, and then 200 mg bid [3-6]. Rilpivirine was stopped and lopinavir/ritonavir added to his antiretroviral regimen. Oxygen therapy with Venturi mask at a 35% FiO2 setting was started. Blood cultures were negative as well as urinary legionella and pneumococcal antigens. Serology for parvovirus B19 and enterovirus was negative, and cytomegalovirus, herpesviruses, Epstein-Barr virus were negative by polymerase chain reaction[7].
The patient’s condition progressively improved. Troponine decreased to 475 ng/L over six days, and a new echocardiogram did not show any changes and did not reveal any vegetations on cardiac valves. The patient was transferred to our Department for follow-up, nine days after admission; his blood pressure remained high and a third echocardiogram detected pulmonary hypertension (PAPs 40+10 mmHg).
 

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