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Coronavirus disease 2019 (COVID-19) has been shown to affect the cardiovascular system, and several cases of takotsubo syndrome (TTS) induced by COVID-19 have been reported. TTS predominantly affects postmenopausal women in western countries, but the prevalence in men is higher in Asian populations. It should be noted that male patients with either TTS or COVID-19 are associated with higher mortality. Despite the higher prevalence of TTS in Asian men, little is known about Asian men with TTS induced by COVID-19. This is a case report of a 60-year-old Asian male with biventricular TTS precipitated by COVID-19. He presented with acute respiratory distress syndrome, cardiogenic shock, and acute kidney injury. He required intubation, multiple vasopressors, and renal replacement therapy. The left ventricular ejection fraction was 15%, but it normalized in 5 weeks. The patient had a prolonged hospital stay in a critical condition, but was eventually discharged alive. The scarce literature about this condition in Asian male populations and the increasing number of COVID-19 cases in Asian countries highlight the rarity and importance of this case. Further studies are warranted to investigate the uneven sex distribution and outcomes of TTS triggered by COVID-19 in an Asian population. < Learning objective: Takotsubo syndrome (TTS) can be provoked by coronavirus disease 2019 (COVID-19). Male sex, right ventricular dysfunction, and COVID-19 as a trigger, are important predicting factors for worse prognosis. It is unknown if there is a significant racial difference in the sex distribution and outcomes for this condition. Further studies are warranted to investigate TTS triggered by COVID-19 in an Asian population.> [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is a global pandemic, and it is increasingly important that physicians recognize and understand its atypical presentations. Neurological symptoms such as anosmia, altered mental status, headache, and myalgias may arise due to direct injury to the nervous system or by indirectly precipitating coagulopathies. We present the first COVID-19 related cases of carotid artery thrombosis and acute PRES-like leukoencephalopathy with multifocal hemorrhage. • COVID-19 may manifest with neurological symptoms • SARS-CoV-2 may have direct neurologic effects due to endothelial invasion, such as our case of PRES-like leukoencephalopathy. • Indirect effects may include coagulation cascade disruption, resulting in unusual thrombosis and large vessel occlusions. [ABSTRACT FROM AUTHOR]

Objective: Coronavirus disease 2019 (COVID-19) continues to spread, and younger patients are also being critically affected. This study analyzed obesity as an independent risk factor for mortality in hospitalized patients younger than 50.Methods: This study retrospectively analyzed data of patients with COVID-19 who were hospitalized to a large academic hospital system in New York City between March 1, 2020, and May 17, 2020. Data included demographics, comorbidities, BMI, and smoking status. Obesity groups included the following: BMI of 30 to < 40 kg/m2 and BMI ≥ 40 kg/m2 . Multivariable logistic regression models identified variables independently associated with mortality in patients younger and older than 50.Results: Overall, 3,406 patients were included; 572 (17.0%) patients were younger than 50. In the younger age group, 60 (10.5%) patients died. In the older age group, 1,076 (38.0%) patients died. For the younger population, BMI ≥ 40 was independently associated with mortality (adjusted odds ratio 5.1; 95% CI: 2.3-11.1). For the older population, BMI ≥ 40 was also independently associated with mortality to a lesser extent (adjusted odds ratio 1.6; 95% CI: 1.2-2.3).Conclusions: This study demonstrates that hospitalized patients younger than 50 with severe obesity are more likely to die of COVID-19. This is particularly relevant in the Western world, where obesity rates are high. [ABSTRACT FROM AUTHOR]