Evidence of SARS-CoV-2 mRNA in endomyocardial biopsies of patients with clinically suspected myocarditis tested negative for COVID-19 in nasopharyngeal swab

Wenzel, Philip; Kopp, Sabrina; Göbel, Sebastian; Jansen, Thomas; Geyer, Martin; Hähn, Felix; Kreitner, K.-F.; Escher, Felicitas; Schultheiß, Heinz Peter; Münzel, Thomas

doi:10.1093/cvr/cvaa160

Cited by 105 publications

(111 citation statements)

References 7 publications

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“…Another multi-organ autopsy study of COVID-19 patients revealed the presence of SARS-CoV-2 viral RNA in the heart tissue [11]. Surprisingly, the SARS-Cov-2 mRNA was found in the heart tissue biopsy of patients who had already recovered from SARS-CoV-2 infection [12]. Moreover, several recent studies described that hiPSC-CMs can be efficiently infected with SARS-CoV-2 particles and such a platform can be further utilized for screening of potential anti-viral medicines [9,13].…”

Section: Discussionmentioning

confidence: 99%

MicroRNAs targeting the SARS-CoV-2 entry receptor ACE2 in cardiomyocytes

Chatterjee

et al. 2020

Journal of Molecular and Cellular Cardiology

100

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The World Health Organization (WHO) declared coronavirus disease 2019 (COVID-19) as a public health emergency of international concern as more than 15 million cases were reported by 24th July 2020. Angiotensinconverting enzyme 2 (ACE2) is a COVID-19 entry receptor regulating host cell infection. A recent study reported that ACE2 is expressed in cardiomyocytes. In this study, we aimed to explore if there are microRNA (miRNA) molecules which target ACE2 and which may be exploited to regulate the SARS-CoV-2 receptor. Our data reveal that both Ace2 mRNA and Ace2 protein levels are inhibited by miR-200c in rat primary cardiomyocytes and importantly, in human iPSC-derived cardiomyocytes. We report the first miRNA candidate that can target ACE2 in cardiomyocytes and thus may be exploited as a preventive strategy to treat cardiovascular complications of COVID-19.

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Section: Discussionmentioning

confidence: 99%

MicroRNAs targeting the SARS-CoV-2 entry receptor ACE2 in cardiomyocytes

Chatterjee

et al. 2020

Journal of Molecular and Cellular Cardiology

100

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“…Given the extensive homology of SARS-CoV-1 and SARS-CoV-2, and the intensity of SARS-CoV-2 binding to ACE2, it is reasonable to presume that SARS-CoV-2 directly invades human myocardium. To date, there have been only a few reports confirming the presence of viral inclusion bodies or the identification of SARS-CoV-2 genomic RNA from myocardial tissue taken from biopsy-proven COVID-19 myocarditis cases ( 17 , 18 , 19 , 20 , 21 , 22 ). In a report of 104 patients with COVID-19 infection who developed acute heart failure and underwent endomyocardial biopsy, 5 were positive for the SARS-CoV-2 genome in the myocardial tissue and associated with typical features of myocarditis, including pronounced intramyocardial inflammation, microvascular thrombosis, and myocardial necrosis.…”

Section: Pathophysiology Of Cardiovascular Involvement In Covid-19mentioning

confidence: 99%

“…The precise incidence of confirmed acute myocarditis at the time of symptomatic COVID-19 infection is currently unclear and mostly limited to case reports in the literature ( 19 , 22 , 67 , 68 , 69 , 70 , 71 , 72 ). However, in a prospective cohort study conducted in Germany of 100 patients recently recovered from COVID-19 who underwent cardiac magnetic resonance (CMR) imaging at a median time interval of 71 days since infection, CMR revealed cardiac involvement in nearly 80% of patients and ongoing myocardial inflammation in 60%.…”

Section: Incidence and Clinical Impact Of Myocardial Injury In Covid-mentioning

confidence: 99%

Coronavirus and Cardiovascular Disease, Myocardial Injury, and Arrhythmia

Giustino

Pinney

Lala

et al. 2020

Journal of the American College of Cardiology

197

213

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The cardiovascular system is affected broadly by severe acute respiratory syndrome coronavirus 2 infection. Both direct viral infection and indirect injury resulting from inflammation, endothelial activation, and microvascular thrombosis occur in the context of coronavirus disease 2019. What determines the extent of cardiovascular injury is the amount of viral inoculum, the magnitude of the host immune response, and the presence of co-morbidities. Myocardial injury occurs in approximately one-quarter of hospitalized patients and is associated with a greater need for mechanical ventilator support and higher hospital mortality. The central pathophysiology underlying cardiovascular injury is the interplay between virus binding to the angiotensin-converting enzyme 2 receptor and the impact this action has on the renin-angiotensin system, the body’s innate immune response, and the vascular response to cytokine production. The purpose of this review was to describe the mechanisms underlying cardiovascular injury, including that of thromboembolic disease and arrhythmia, and to discuss their clinical sequelae.

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“…SARS-CoV, which also binds to the ACE2 receptor, was detected in 35% of hearts [ 101 ] and present in cardiomyocytes that displayed vacuolar degeneration, atrophy and cytoplasmic lysis [ 102 ]. While SARS-CoV-2 has been detected in hearts of COVID-19 patients, no reports yet have shown conclusive evidence of direct SARS-CoV-2 infection in non-inflammatory myocardial cells in COVID-19 patients [ [103] , [104] , [105] , [106] ]. Several cell cardiac cell types express ACE2, including cardiomyocytes [ 107 ].…”

Section: Sex Differences In Covid-19-related Cardiovascular Injurymentioning

confidence: 99%

Sex differences underlying preexisting cardiovascular disease and cardiovascular injury in COVID-19

Medzikovic¹,

Cunningham²,

Li³

et al. 2020

Journal of Molecular and Cellular Cardiology

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The novel 2019 coronavirus disease (COVID-19), resulting from severe acute respiratory syndrome coronarvirus-2 (SARS-CoV-2) infection, typically leads to respiratory failure in severe cases; however, cardiovascular injury is reported to contribute to a substantial proportion of COVID-19 deaths. Preexisting cardiovascular disease (CVD) is among the most common risk factors for hospitalization and death in COVID-19 patients, and the pathogenic mechanisms of COVID-19 disease progression itself may promote the development of cardiovascular injury, increasing risk of in-hospital death. Sex differences in COVID-19 are becoming more apparent as mounting data indicate that males seem to be disproportionately at risk of severe COVID-19 outcome due to preexisting CVD and COVID-19-related cardiovascular injury. In this review, we will provide a basic science perspective on current clinical observations in this rapidly evolving field and discuss the interplay sex differences, preexisting CVD and COVID-19-related cardiac injury.

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Evidence of SARS-CoV-2 mRNA in endomyocardial biopsies of patients with clinically suspected myocarditis tested negative for COVID-19 in nasopharyngeal swab

Cited by 105 publications

References 7 publications

MicroRNAs targeting the SARS-CoV-2 entry receptor ACE2 in cardiomyocytes

MicroRNAs targeting the SARS-CoV-2 entry receptor ACE2 in cardiomyocytes

Coronavirus and Cardiovascular Disease, Myocardial Injury, and Arrhythmia

Sex differences underlying preexisting cardiovascular disease and cardiovascular injury in COVID-19

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