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Later in the hospital course, his pulmonary oedema and respiratory failure worsened as result of severe acute mitral valve regurgitation secondary to direct valvular damage from COVID-19 infection. The patient underwent emergent surgical mitral valve replacement. Pathological evaluation of the damaged valve was confirmed to be secondary to COVID-19 infection. The histopathological findings were consistent with prior cardiopulmonary autopsy sections of patients with COVID-19 described in the literature as well as proposed theories regarding ACE2 receptor activity. This case highlights the potential of SARS-CoV-2 causing direct mitral valve damage resulting in severe mitral valve insufficiency with subsequent pulmonary oedema and respiratory failure.<\/jats:p>","DOI":"10.1136\/bcr-2020-239782","type":"journal-article","created":{"date-parts":[[2021,1,18]],"date-time":"2021-01-18T12:39:33Z","timestamp":1610973573000},"page":"e239782","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["Severe acute mitral valve regurgitation in a COVID-19-infected patient"],"prefix":"10.1136","volume":"14","author":[{"given":"Ayesha","family":"Khanduri","sequence":"first","affiliation":[{"name":"Graduate Medical Education, WellStar Health System, Marietta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usha","family":"Anand","sequence":"additional","affiliation":[{"name":"Graduate Medical Education, WellStar Health System, Marietta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maged","family":"Doss","sequence":"additional","affiliation":[{"name":"Graduate Medical Education, WellStar Health System, Marietta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louis","family":"Lovett","sequence":"additional","affiliation":[{"name":"Graduate Medical Education, WellStar Health System, Marietta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,18]]},"reference":[{"key":"2025082800013245000_14.1.e239782.1","unstructured":"Centers for Disease Control and Prevention; 2020 [updated . 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