Xiao-xiao Ni,1,* Zhe-ying Liu,2,* Yan-yan Zeng,1,* Zhi-feng Liu2 

1Department of Hyperbaric Oxygen Medicine and Rehabilitation, General Hospital of Southern Theater Command of PLA, Guangzhou, Guangdong, People’s Republic of China; 2Department of Medicine Intensive Care Unit, General Hospital of Southern Theater Command of PLA, Guangzhou, Guangdong, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Zhi-feng Liu, Department of Medicine Intensive Care Unit, General Hospital of Southern Theatre Command of PLA, Guangzhou, Guangdong, People’s Republic of China, Email Zhifengliu7797@163.com

Background: Hyperthermia and multiple organ dysfunction syndrome (MODS) are the main characteristics of heatstroke and COVID-19. Differentiating between these illnesses is crucial during a summer COVID-19 pandemic, but cases of heatstroke comorbid with COVID-19 are rarely reported.
Case description: We report the first case of heatstroke comorbid with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in a 52-year-old male. After receiving intravenous antibiotics, organ protection measures, and treatment for coagulation disorders, his fever and coma resolved. However, he developed dyspnea and cerebral hemorrhage after several days. This patient experienced a multi-pathogen pulmonary infection and an intractable coagulopathy that ultimately resulted in MODS and death.
Conclusion: The combination of heatstroke and SARS-CoV-2 infection exacerbated inflammation, immune abnormalities, and coagulation disorders. The interaction between inflammation and coagulation disturbances contributed to the underlying mechanism in this case, highlighting the importance of early anti-infection, treatment for coagulopathy, immune regulation, and organ protection as crucial interventions.

Keywords: heatstroke, COVID‐19, infection, coagulation disorder, cerebral hemorrhage