Τίτλος:
COVID-19 and myocarditis: a systematic review and overview of current challenges
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Myocardial inflammation in COVID-19 has been documented. Its pathogenesis is not fully elucidated, but the two main theories foresee a direct role of ACE2 receptor and a hyperimmune response, which may also lead to isolated presentation of COVID-19-mediated myocarditis. The frequency and prognostic impact of COVID-19-mediated myocarditis is unknown. This review aims to summarise current evidence on this topic. We performed a systematic review of MEDLINE and Cochrane Library (1/12/19–30/09/20). We also searched clinicaltrials.gov for unpublished studies testing therapies with potential implication for COVID-19-mediated cardiovascular complication. Eligible studies had laboratory confirmed COVID-19 and a clinical and/or histological diagnosis of myocarditis by ESC or WHO/ISFC criteria. Reports of 38 cases were included (26 male patients, 24 aged < 50 years). The first histologically proven case was a virus-negative lymphocytic myocarditis; however, biopsy evidence of myocarditis secondary to SARS-CoV-2 cardiotropism has been recently demonstrated. Histological data was found in 12 cases (8 EMB and 4 autopsies) and CMR was the main imaging modality to confirm a diagnosis of myocarditis (25 patients). There was a substantial variability in biventricular systolic function during the acute episode and in therapeutic regimen used. Five patients died in hospital. Cause-effect relationship between SARS-CoV-2 infection and myocarditis is difficult to demonstrate. However, current evidence demonstrates myocardial inflammation with or without direct cardiomyocyte damage, suggesting different pathophysiology mechanisms responsible of COVID-mediated myocarditis. Established clinical approaches should be pursued until future evidence support different actions. Large multicentre registries are advisable to elucidate further. © 2021, The Author(s).
Συγγραφείς:
Castiello, T.
Georgiopoulos, G.
Finocchiaro, G.
Claudia, M.
Gianatti, A.
Delialis, D.
Aimo, A.
Prasad, S.
Περιοδικό:
Heart Failure Reviews
Λέξεις-κλειδιά:
cardiovascular magnetic resonance; clinical feature; coronavirus disease 2019; disease severity; echocardiography; electrocardiogram; heart muscle biopsy; histology; human; incidence; mortality rate; myocarditis; Review; risk factor; systematic review; cardiac muscle cell; male; myocarditis; register, COVID-19; Humans; Male; Myocarditis; Myocytes, Cardiac; Registries; SARS-CoV-2
DOI:
10.1007/s10741-021-10087-9
