Background: Covid-19 is an extremely contagious illness caused by the severe acute respiratory syndrome (SARS-CoV-2) virus. The cardiac involvement in such a public health emergency disease has not been well studied and a conflicting evidence exists on this issue. Objective: This systematic review article aimed to compile and illustrate clinical characteristics, diagnostic findings, management, and outcomes manifesting in myocarditis linked with Covid-19. Methods: A literature search was accomplished for published eligible articles with MEDLINE/PubMed and Embase databases. All eligible case reports and case series were included from around the world without any language restrictions. For this review, inclusion criteria were laboratory-confirmed SARS-CoV-2 infection cases reporting a diagnosis of acute myocarditis. Results: Data from 41 studies describing myocarditis in 42 Covid-19 patients was obtained. The median age of these patients was 43.4 years, with 71.4% of them being men. Fever was the most prevalent presenting symptoms seen in 57% of patients. Hypertension was the most pervasive comorbidity accompanying these patients. Cardiac biomarkers troponin and brain natriuretic peptide (BNP) were raised in almost 90% and 87% of patients, respectively. Electrocardiogram findings were nonspecific and included ST-segment and T-wave changes. Echocardiogram commonly showed left ventricular systolic dysfunction with increased heart size. Cardiac magnetic resonance imaging (CMRI) exhibited myocardial edema and injury. The most prevalent histopathological feature appreciated was diffuse lymphocytic inflammatory infiltrates. Antivirals and corticosteroids were the most frequently used medications. About 38% of patients also needed vasopressor assistance. Out of 42 patients, 67% recovered, and eight died.
Conclusion:Because of the risk of a sudden worsening of patients conditions and myocarditis association with considerable mortality and morbidity, a knowledge of this cardiac complication of Covid-19 disease is crucial for healthcare professionals.
Background: Covid-19 is an extremely contagious illness caused by the
severe acute respiratory syndrome (SARS-CoV-2) virus. Although this
disease primarily involves pulmonary tissue, rapidly advancing research
has established cardiac involvement in Covid-19 patients. Objective:
This systematic review article aimed to compile and illustrate clinical
characteristics, diagnostic findings, management, and outcomes
manifesting in myocarditis linked with Covid-19. Methods: A literature
search was accomplished for published eligible articles with
MEDLINE/PubMed and Embase databases. All eligible case reports and case
series were included from around the world without any language
restrictions. For this review, inclusion criteria were
laboratory-confirmed SARS-CoV-2 infection cases reporting a diagnosis of
acute myocarditis. Results: Data from 41 studies describing myocarditis
in 42 Covid-19 patients was obtained. The median age of these patients
was 43.4 years, with 71.4% of them being male. Fever was the most
prevalent presenting symptoms seen in 57% of patients. Hypertension was
the most pervasive comorbidity accompanying these patients. Cardiac
biomarkers troponin and Brain natriuretic peptide (BNP) were raised in
almost 90% and 87% of patients, respectively. Electrocardiogram
findings were Non-specific and included ST-segment and T-wave changes.
The most prevalent histopathological feature appreciated was diffuse
lymphocytic inflammatory infiltrates. Antivirals and corticosteroids
were the most frequently used medications. About 38% of patients also
needed vasopressor assistance. Out of 42 patients, 67% recovered, and
eight died. Conclusion: Due to the risk of a sudden worsening of
patients conditions and myocarditis association with considerable
mortality and morbidity, a knowledge of this cardiac complication of
Covid-19 disease is crucial for healthcare professionals.
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