Case report: postoperative myocardial injury in a patient with left ureteric stone and asymptomatic COVID-19 disease

Nadeem Kassam, Aga Khan University
Omar Aziz, Aga Khan Hospital
Ally Zain Ismail, Aga Khan University
Rodgers Swai, Aga Khan Hospital
Samina Somji, Aga Khan University
Robert Mvungi, Aga Khan Hospital
Mustaafa Bapumia, Aga Khan University
Ali Akbar Zehri, Aga Khan University
Salim Surani, USA


Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It was first identified on 8thDecember 2019 in Wuhan, Hubei, China, and has since spread globally to become an emergency of international concern. Patients infected with SARS-CoV-2 may be asymptomatic or present with symptoms ranging from mild clinical manifestations: such as fever, cough, and sore throat to moderate and severe form of the disease such as pneumonia and acute respiratorydistress syndrome (ARDS). In some patients, SARS-CoV-2 can affect the heart and cause myocardial injury which is evidenced either by electrocardiographic (ECG) changes or by a rise in serum troponin level. Patients with myocardial involvement are generally at risk of developing severe illness and tend to have a poor outcome. We hereby present a case of a hypertensive male patient with undiagnosed, asymptomatic COVID-19, who underwent an emergency urologic procedure for ureteric calculi. He eventually sustained a postoperative myocardial injury resulting in his demise. This case highlights the importance of detailed preoperative assessment and anticipation of complications during this global pandemic.