Case report of cardiogenic shock in COVID-19 myocarditis: peculiarities on diagnosis, histology, and treatment

Abstract

Background the year 2020 was dramatically characterized by SARS-CoV-2 pandemic outbreak. COVID-19-related heart diseases and myocarditis have been reported. Case summary a 45-year-old healthy male was admitted to the intensive care unit of our hospital because of cardiogenic shock. A diagnosis of COVID-19 infection and myocarditis was done. We present here several peculiarities about diagnostic workup, myocardial histological findings, choice of treatment and the patient clinical course at three and eight-months of follow-up. Discussion COVID-19 myocardial damage and myocarditis are mainly linked to the cytokine storm with mild myocardial inflammatory infiltrate and very unusual platelet microclots in the setting of the microvascular obstructive thrombo-inflammatory syndrome. Counteracting the inflammatory burden with an interleukine-1 inhibitor appeared safe and led to a dramatic and stable improvement of cardiac function.

Management of a critically ill patient with COVID-19-related fulminant myocarditis: A case report

“…The severity of COVID-19 is not necessarily related to the occurrence of myocarditis. It means that some cases with mild involvement of lung parenchyma may be presented with acute myocarditis, while others may have severe involvement of lungs in imaging [ 18 ]. This highlights the importance of awareness about the occurrence of cardiomyopathy and cardiovascular involvement, even in mild cases, and probable further requirement of follow-up in suspected cases.…”

The benefit of vaccination against COVID-19 outweighs the potential risk of myocarditis and pericarditis

“…Viruses are the primary cause of myocarditis, including amongst others adeno- and enteroviruses. Recently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been associated with myocarditis as well, and multiple cases have been described since the outbreak of the COVID-19 pandemic [ 14 , 15 ].…”

“…Viruses are the primary cause of myocarditis, including amongst others adeno-and enteroviruses. Recently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been associated with myocarditis as well, and multiple cases have been described since the outbreak of the COVID-19 pandemic [14,15]. The CAPACITY-COVID collaborative consortium recently published data on more than 16,000 patients hospitalised with COVID-19 across 18 countries, of whom 0.2% and 0.15% were diagnosed with myocarditis or pericarditis during admission in a routine care setting, respectively [16].…”