First Documentation of Persistent SARS-Cov-2 Infection Presenting With Late Acute Severe Myocarditis

Pavon, Anna Giulia; Meier, David; Samim, Daryoush; Rotzinger, David C.; Fournier, Stéphane; Marquis, Patrick; Monney, Pierre; Müller, Olivier; Schwitter, Juerg

doi:10.1016/j.cjca.2020.06.005

Cited by 27 publications

(24 citation statements)

References 5 publications

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“…SARS-CoV-2 All reported cases (except the case which included the 17-year-old patient) presented with increased levels of troponin ranging from 590 to 11.000 ng/L [14][15][16][17][18][19][20][21][22][23]. Four of them had elevated NT-pro-BNP levels that ranged between 1300 and 8465 pg/ml [16][17][18][19] and two had elevated NT-BNP levels which peak accounted for 22.600 pg/ml [15,21].…”

Section: Laboratory Findingsmentioning

confidence: 98%

“…Acute myocarditis may present with chest pain, fever, dyspnoea, signs of heart failure and ECG abnormalities like STinterval or T-wave changes. [13] SARS-CoV-2 We reviewed ten published case reports of infection by SARS-CoV-2, presenting as acute myocarditis [14][15][16][17][18][19][20][21][22][23]. The cases included 6 male and 3 female patients, aged between 17 and 69 years.…”

Section: Clinical Presentation-symptoms and Signsmentioning

confidence: 99%

“…Five of the patients presented with chest pain [14,15,19,21,23]. Dyspnoea was another main symptom reported in 6 cases [15,16,18,[21][22][23]. More details regarding their clinical presentation are presented in Table 1.…”

Section: Clinical Presentation-symptoms and Signsmentioning

confidence: 99%

“…Echocardiography revealed a wide range of findings. Seven out of nine patients had moderate to severe left ventricular dysfunction (left ventricular ejection fraction ranging between 25 and 40%) [15,17,19,21,23]. Other findings included increased wall thickness, hypokinesia and pericardial effusion [15, 17-19, 21, 23].…”

Section: Laboratory Findingsmentioning

confidence: 99%

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Acute Myocarditis Related to COVID-19: Comparison to SARS and MERS

Chasouraki

Violetis

Abdel‐Rasoul

et al. 2020

SN Compr. Clin. Med.

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Myocardial involvement has been described during previous SARS and MERS outbreaks. Infection by SARS-CoV-2 (COVID-19) can range from asymptomatic to life-threatening multi-system disease. Heart involvement most commonly occurs during severe COVID-19 infection. Myocardial injury, based on elevated levels of myocardial enzymes, has been noted in up to 30% of patients with COVID-19 infection and could be a marker for worse prognosis. A few cases of possible myocarditis due to SARS-CoV-2 have been described, providing variable degree of evidence of direct myocardial involvement. We reviewed in detail those cases in comparison to relevant literature on SARS and MERS and attempted to draw initial conclusions in regard to clinical presentation, treatment and prognosis.

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Section: Laboratory Findingsmentioning

confidence: 98%

Section: Clinical Presentation-symptoms and Signsmentioning

confidence: 99%

Section: Clinical Presentation-symptoms and Signsmentioning

confidence: 99%

Section: Laboratory Findingsmentioning

confidence: 99%

See 2 more Smart Citations

Acute Myocarditis Related to COVID-19: Comparison to SARS and MERS

Chasouraki

Violetis

Abdel‐Rasoul

et al. 2020

SN Compr. Clin. Med.

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“…There is concern that even ‘recovered’ patients may be at risk of adverse cardiac events. Evidence is limited to date, but Pavon et al reported a case of severe myocarditis in a 64-year-old man 6 weeks after an initial, almost asymptomatic, SARS-CoV-2 infection [ 7 ].…”

mentioning

confidence: 99%

COVID-19, the heart and returning to physical exercise

Kennedy¹,

Sharma

2020

Occupational Medicine

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Clinical variants of myocardial involvement in COVID-19-positive patients: a cumulative experience of 2020

et al. 2021

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Myocardial injury, diagnosed by troponin elevation, is common in COVID-19 patients, but cardiac involvement with clinical manifestations occurs less frequently. We analyzed the literature on COVID-19 (2020) and systematically reviewed the cases where individual patient data were presented. We searched PubMed and Google Scholar for "COVID," "COVID-19," and "coronavirus" in combination with "myocarditis," "heart failure," "takotsubo," "cardiomyopathy," and "cardiogenic shock." We identified 90 cases of COVID-19 with myocardial involvement, mean age 52.9 ± 18.3 years, 54.5% males. Of them, 55 survived (61.1%), 20 died (22.2%), and in 15 (16.7%) the outcome was unknown at the time of publication. Among patients with known outcome, mortality was 26%. The nadir LVEF was 31.7 ± 13.1% and recovered to 50.1 ± 16.0%. Pericardial effusion was a common finding, reported in 21 (23.3%) of patients, including moderate size effusion in 8.9% and large in 7.8%. The effusion caused tamponade in 11 (12.2%) of patients. Out of 83 patients who experienced a decrease in LVEF, 30 could be classified as takotsubo syndrome. The takotsubo patients were older than those with myocarditis, and with relatively high proportion of males. About one third of the cases was complicated by cardiogenic shock. Myocardial involvement in COVID-19 patients most often presents as a new, rapid decrease in LVEF, although normal LVEF or takotsubo-like wall motion pattern does not rule out myocarditis. Moderate and large pericardial effusion is common, and cardiac tamponade occurs in 12.2% of patients. Cardiogenic shock develops in one third of the patients. Mortality appears to be high at 26%.

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First Documentation of Persistent SARS-Cov-2 Infection Presenting With Late Acute Severe Myocarditis

Cited by 27 publications

References 5 publications

Acute Myocarditis Related to COVID-19: Comparison to SARS and MERS

Acute Myocarditis Related to COVID-19: Comparison to SARS and MERS

COVID-19, the heart and returning to physical exercise

Clinical variants of myocardial involvement in COVID-19-positive patients: a cumulative experience of 2020

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