I thought I'd share these cases. This past week, I've had 2 hospital COVID-19 pts, both admitted to non-ICU COVID floor. 46 and 70 y/o males. Mild moderate hypoxia from viral PNA. No antecedent cardiac history. Both had acute VT/VF cardiac arrests. The 70 y/o passed. The 46 y/o was resuscitated and intubated, with ROSC. Has now cardiac EF 15-20% by ECHO. 3 pressors from severe cardiogenic shock. Possible balloon pump pending. Vent maxed. Not looking good.

I have had several other of these since March. Needless to say myocardial involvement is ominous.

I am starting to think that ECHOs and EKGs weekly on these pts may be indicated? Maybe more cardiology consults. We (pulmonary) are consulted on all. Regardless of pulm status. Admittedly myocardial involvement is less common. But, high fatality rates.

Long time lurker on the forum. Advanced HF doc. Just my first thoughts from reading your experience.

Agree HF/myocarditis in these pts carries a poor prognosis and usually associated with more severe disease. Monitoring is good, but would it change overall trt (outside of additional HF management). I assume these pts were already on steroids. Would this trigger use of toci or other immune modulators? From a resource standpoint maybe following serial troponins and ecg and if sig change then get an echo?
Not wanting to sound critical at all. Just a couple of first pass thoughts.

In cases like these would an autopsy be done?

The key here is that they had no "known" cardiac history, but likely had underlying cardiac disease that was previously undiagnosed. Difficult to know after the fact, but likely a contributing factor.