A team of University of Pavia, Italy presents on Lancet the case of 16-year-old boy admitted to emergency department, complaining of intense chest pain started 1 h earlier. The day before he had a fever of 38·3°C that
decreased after 100 mg of nimesulide. He reported no other symptoms, no medical history, and no contact with anyone with confirmed COVID-19.

An electrocardiogram (ECG) showed inferolateral ST-segment elevation and a transthoracic echocardiography showed hypokinesia of the inferior and inferolateral segments of the left ventricle, with a preserved ejection fraction of 52%; no pericardial effusion was seen. Investigations showed
raised high-sensitivity cardiac troponin I (9449 ng/L), creatine phosphokinase (671·0 U/L), C-reactive protein (32·5 mg/L), and lactate dehydrogenase (276·0 U/L) concentrations. The leucocyte count was 12·75×10⁹ per L, the neutrophil count was 10·04×10⁹ per L and the lymphocyte count was 0·78×10⁹ per L.

On day 3, a nasopharyngeal swab test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was positive.
Serial measurements of the patient’s troponin concentration showed a gradual reduction from a peak of 16862 ng/L on day 1, to 39 ng/L on day 8. The inflammatory markers also returned to normal and the ST-segment
elevation on ECG resolved.

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