A clinical case of development of Waterhouse-Friderichsen syndrome after SARS-CoV-2 infection in a patient with rheumatoid arthritis and secondary adrenal AA-amyloidosis

Abstract

We present a clinical observation of a patient whose cause of death was a new coronavirus infection COVID-19 complicated by bilateral viral interstitial pneumonia and adult acute respiratory distress syndrome. The presence of background diseases-rheumatoid arthritis and secondary AA-adrenal amyloidosis-worsened the prognosis. Waterhouse-Friderichsen syndrome with hemorrhage and foci of necrosis in the adrenal cortex developed against a background of SARS-CoV-2 infection. The unique feature of this case is the long-term favorable course of the disease and its rapid progression after infection with SARS-CoV-2. The associated syndrome of disseminated intravascular coagulation further aggravated the patient's condition.