A 21-years-old with Down syndrome presented with respiratory distress Initial investigations revealed a cardiac tamponade On further evaluation, he had positive coronavirus disease-2019 (COVID-19), severe chest infection and severe hypothyroidism He responded well to urgent pericardiocentesis, levothyroxine, hydrocortisone and tocilizumab
Cardiac Tamponade, Sever Hypothyroidism and Acute Respiratory Distress Syndrome (ARDS) with COVID-19 Infection