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As health systems worldwide grapple with the COVID-19 pandemic, patients on durable LVAD support represent a unique population at risk for the disease. We outline such a patient who developed COVID-19 complicated by "cytokine storm" with severe ARDS and myocardial injury; and describe the challenges that arose during management.

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Coronavirus disease 2019 (COVID-19) has been associated with a range of hematologic findings and complications [1]. We have encountered three cases of significant methemoglobinemia, and five cases of relatively mild methemoglobinemia, among patients being treated for COVID-19 in our health system during a 4 week period in April 2020. For comparison, there was only one case of mild acquired methemoglobinemia of any cause documented in our health system during the preceding year. Below we describe the three cases of significant methemoglobinemia, including their presentations, treatments, and outcomes.