Comprehensive Management Conferring an Improved Outcome for a post -COVID-19 Patient With Congestive Heart Failure: A Case Report

Background: The COVID-19 pandemic has been unresolved for 3 years. Numerous individuals have survived COVID-19 but suffered from a variety of problems or symptoms for several months. This report presents our experience regarding a post-COVID-19 patient with exacerbated symptoms of congestive heart failure and congestive hepatopathy. Result: Two months after being diagnosed with COVID-19, a 47- year-old man presented to Universitas Islam Indonesia Hospital with significant shortness of breath and abdominal enlargement. Cardiomegaly, increased jugular venous pressure, hepatomegaly, ascites, and bilateral edema of the legs were all indicators of congestive heart failure. Cardiomegaly was discovered on a chest X-ray. Electrocardiography revealed ischemic heart illness with an old myocardial infarction. Aspartate transaminase (911 U/L), alanine transaminase (820 U/L), and total bilirubin (4-6 mg/dL) were increased. Ultrasonography of the abdomen demonstrated congestive hepatopathy with ascites. Echocardiography showed hypokinetic cardiac wall movements and a 21% decrease in the ejection fraction. He had a comorbidity of uncontrolled diabetes mellitus. The symptoms subsided after therapy with furosemide, spironolactone, dobutamine, nebivolol, sacubitril, valsartan, Lornithine-L-aspartate, insulin, and a broad spectrum of antibiotics. After 10 days of hospitalization with comprehensive management, the patient's condition improved. Conclusions: Our post-COVID-19 patient suffering from congestive heart failure with a poor ejection fraction and severe congestive hepatopathy had an improved outcome following our comprehensive management.