Chest pain and high troponin level without significant respiratory symptoms in young patients with COVID-19

Background: Of all patients infected with COVID-19, 95% have mild symptoms, but 5% may experience severe illness. There are reports of myocardial injury associated with the COVID19 infection in middle aged and old people with baseline cardiac conditions. Acute myocardial injury has been suggested as a marker for disease severity. Sometimes it is hard to differentiate between acute coronary syndrome and acute myocarditis; hence detailed history taking, lab tests and imaging will be necessary. Case Presentation: Herein, we described two young patients presenting with chest pain and no significant respiratory symptoms, one without cardiovascular risk factors and another one with diabetes mellitus and cigarette smoking. COVID-19 was documented with real-time reverse-transcriptase-polymerase chain reaction (rRT-PCR). Conclusion: Early Chest CT scan besides coronary CT angiogram (if available) in suspicious cases can help physician to make fast decisions. These two cases both had complication-free hospital stay. Despite markedly high on-admission troponin levels, which is known as a marker of poor prognosis they discharged in good condition. One month follow-up was also uneventful.