Fatal COVID‐19 infection in a patient with long‐chain 3‐hydroxyacyl‐CoA dehydrogenase deficiency: A case report

Abstract

Long‐chain fatty‐acyl CoA dehydrogenase deficiency (LCHADD) is an inborn error of long chain fatty acid oxidation with various features including hypoketotic hypoglycemia, recurrent rhabdomyolysis, pigmentary retinopathy, peripheral neuropathy, cardiomyopathy, and arrhythmias. Various stresses trigger metabolic decompensation. Coronavirus disease 2019 (COVID‐19) is a pandemic caused by the RNA virus SARS‐CoV‐2 with diverse presentations ranging from respiratory symptoms to myocarditis. We report a case of a patient with LCHADD who initially presented with typical metabolic decompensation symptoms including nausea, vomiting, and rhabdomyolysis in addition to mild cough, and was found to have COVID‐19. She developed acute respiratory failure and refractory hypotension from severe cardiomyopathy which progressed to multiple organ failure and death. Our case illustrates the need for close monitoring of cardiac function in patients with a long‐chain fatty acid oxidation disorder.

COVID-19 in Unvaccinated patients with inherited metabolic disorders: A single center experience

“…Most of the hospitalized patients were adults (16/22) with intoxication disorders (MMA, PA, and ASA) and 8 of those patients, in addition to a patient with Very long-chain Acyl-CoA dehydrogenase deficiency (VLCADD), developed severe symptoms and required intensive care management. This echoes the same course of previously reported IMD patients under these two categories ( Sibulo et al, 2021 ; Saad-Naguib et al, 2021 ; Kaur et al, 2021 ; Caciotti et al, 2020 ; Wongkittichote et al, 2020 ). Metabolic acidosis was mainly reported in patients with organic acidemias, while hyperammonemia was seen in ASA and PA patients.…”

“…Death due to complicated cardiomyopathy and heart failure during COVID-19 infection was reported in an infant with MPS-I ( Climent et al, 2020 ). Another reports of death were in a patient with Long-chain fatty-acyl CoA dehydrogenase deficiency due to COVID-19 complications and in another patient with Niemann-Pick C from complicated COVID-19 pneumonia and respiratory failure ( Wongkittichote et al, 2020 ; Tobór-Świętek et al, 2021 ). None of our patients with energy metabolism disorders died though, two of them developed rhabdomyolysis crisis during their COVID-19 illness.…”

“…Studies on the impact and the outcome of COVID-19 infection in IMD patients are scarce. There are a few reports on the clinical impact of COVID-19 infection in IMD patients with different clinical responses ranging from mild to severe presentation ( Zubarioglu et al, 2021 ; Sibulo et al, 2021 ; Saad-Naguib et al, 2021 ; Kaur et al, 2021 ; Caciotti et al, 2020 ; Wongkittichote et al, 2020 ; Climent et al, 2020 ; Lampe et al, 2020 ; Tummolo et al, 2021 ; Tobór-Świętek et al, 2021 ). Due to the uniqueness of this group of patients and the lack of extensive literature reports, the management of COVID-19 infection has been challenging for many health care providers ( Lampe et al, 2020 ; Tobór-Świętek et al, 2021 ).…”

The Impact of COVID-19 on the Cardiovascular Health of Emerging Adults Aged 18-25: Findings From a Scoping Review

“…The grey literature search located no additional sources. Altogether, the evidence in this review includes 117 case reports/series 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 , 96 , 28 observational studies 10 , 11 , 139 , 140 , 141 , 142 , 143 , 144 , 145 , 146 , 147 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 , 161 , 162 , 163...…”

Gene Variants Related to Cardiovascular and Pulmonary Diseases May Correlate with Severe Outcome of COVID-19

“…Interestingly, one study showed that mutations in the HADHA gene should be considered as a risk factor for a severe outcome of COVID-19. The patient, described in a single case report, with pathogenic variants in HADHA, suddenly developed acute respiratory failure due to COVID-19 infection, accompanied by refractory hypotension from severe cardiomyopathy which led to multiple organ failure and death [ 19 ].…”