Case Report: Effects of Sars-CoV-2 on Marfan syndrome with resulting acute aortic dissection.
Jennifer J DeVries, Holly A Myers
PMID 36435601WHAT IT FOUND
A patient with Marfan syndrome and prior aortic dissection repair developed acute aortic dissection during SARS-CoV-2 pneumonia and died.
This single case cannot prove SARS-CoV-2 caused the dissection or guide treatment.
Key findings
01In a patient with Marfan syndrome and prior Type A and B dissection repair who had a positive SARS-CoV-2 PCR, CT showed acute Type A aortic dissection distal to the previous repair.
02The patient was not deemed a surgical candidate because of worsening respiratory status, hemodynamic instability, and complex comorbidities, and care was withdrawn.
03The authors suggest delayed aortic root repair and delayed SARS-CoV-2 testing may have affected the outcome.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This is a single case report, so it cannot show that SARS-CoV-2 caused the aortic dissection. The patient had many conditions and events at once, including Marfan syndrome, prior dissection repair, delayed aortic root repair, hypertension, heart failure, atrial fibrillation, kidney injury, pneumonia, and delayed testing, so the contribution of each factor cannot be separated. The supplied text does not describe a comparison group or a primary outcome. The Discussion notes delayed care and fear of exposure as possible contributors, but these are author interpretation, not measured results.
The easy way to misread this
Do not read this as proof that SARS-CoV-2 caused the aortic dissection. This is a single case report, and the patient had Marfan syndrome, prior dissection repair, delayed root repair, hypertension, heart failure, atrial fibrillation, kidney injury, and pneumonia, so no single factor can be separated as the cause.