Management of COVID-19 myopericarditis with reversal of cardiac dysfunction after blunting of cytokine storm: a case report

Li, Angela; Garcia-Bengochea, Youssef; Stechel, Richard; Azari, Bani

doi:10.1093/ehjcr/ytaa224

Cited by 16 publications

(31 citation statements)

References 14 publications

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“…Additionally, compounds must also be evaluated for cellular toxicity. The cytotoxic effect of In addition to inhibition of viral replication, blunting this inflammatory response before overt cytokine storm is important to improve outcomes [7,16,17]. Although remdesivir and convalescent plasma are used for this purpose, there is a need for adjunct treatments to ameliorate disease burden.…”

Section: Introductionmentioning

confidence: 99%

In Vitro Assessment of the Antiviral Activity of Ketotifen, Indomethacin and Naproxen, Alone and in Combination, against SARS-CoV-2

Kiani

Scholey

Dahl³

et al. 2021

Viruses

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The 2019 coronavirus infectious disease (COVID-19) is caused by infection with the new severe acute respiratory syndrome coronavirus (SARS-CoV-2). Currently, the treatment options for COVID-19 are limited. The purpose of the experiments presented here was to investigate the effectiveness of ketotifen, naproxen and indomethacin, alone or in combination, in reducing SARS-CoV-2 replication. In addition, the cytotoxicity of the drugs was evaluated. The findings showed that the combination of ketotifen with indomethacin (SJP-002C) or naproxen both reduce viral yield. Compared to ketotifen alone (60% inhibition at EC50), an increase in percentage inhibition of SARS-CoV-2 to 79%, 83% and 93% was found when co-administered with 25, 50 and 100 μM indomethacin, respectively. Compared to ketotifen alone, an increase in percentage inhibition of SARS-CoV-2 to 68%, 68% and 92% was found when co-administered with 25, 50 and 100 μM naproxen, respectively. For both drug combinations the observations suggest an additive or synergistic effect, compared to administering the drugs alone. No cytotoxic effects were observed for the administered dosages of ketotifen, naproxen, and indomethacin. Further research is warranted to investigate the efficacy of the combination of ketotifen with indomethacin (SJP-002C) or naproxen in the treatment of SARS-CoV-2 infection in humans.

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Section: Introductionmentioning

confidence: 99%

In Vitro Assessment of the Antiviral Activity of Ketotifen, Indomethacin and Naproxen, Alone and in Combination, against SARS-CoV-2

Kiani

Scholey

Dahl³

et al. 2021

Viruses

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show abstract

“…The effects of this virus include potential effects on the conducting system, 9 development of arrhythmias, 10 coronary artery disease, 11 thrombosis, 12 and myocardial effects. 13 , 14 In addition, there is a suggestion that underlying cardiac disease may contribute to poor outcomes from SARS-CoV2 infection. 15 This collection is an excellent repository demonstrating the clinical effects of COVID-19 on the cardiovascular system.…”

mentioning

confidence: 99%

The cardiac effects of SARS-CoV2: COVID-19 special issue

Camm

2020

European Heart Journal - Case Reports

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“…Medications that have been employed so far in pericardial disease related to COVID-19 include colchicine, NSAIDs including aspirin, steroids, and intravenous immunoglobulins (IVIG) [ 6 , 7 , 17 ]. Colchicine has been used alone or in combination with NSAIDs successfully [ 5 , 7 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

“…Colchicine has been used alone or in combination with NSAIDs successfully [ 5 , 7 , 10 ]. Li et al reported a case of a hemodynamically unstable patient with COVID-19 myopericarditis who responded well to IVIG and methylprednisolone [ 17 ]. At the beginning of the pandemic, there was some safety concern related to NSAIDs use in COVID-19 [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Challenges in Managing Pericardial Disease Related to Post Viral Syndrome After COVID-19 Infection

Sollie¹,

Vallepu²,

Jagadeesan³

et al. 2021

Cureus

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Although primarily a respiratory illness, coronavirus disease 2019 (COVID-19) has been associated with cardiac involvement with reported cases of myocardial ischemia, arrhythmia, myocarditis, pericarditis, and pericardial effusion leading to cardiac tamponade. Most cases of pericardial disease in this setting have been during the acute infection. Here, we present a patient who developed pericarditis leading to cardiac tamponade after the resolution of the acute COVID-19 infection. Her course of illness was further complicated by poor response to initial medical therapy with non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine which could possibly be related to early exposure to steroids. It is often difficult to establish an underlying etiology for acute pericarditis. Similarly, in our case, although there is no definitive test to prove the causal relationship, this effusion is highly suspicious of being secondary to post viral sequelae after COVID-19 infection when considering the clinical course. It is important to consider pericardial disease as a late complication of COVID-19 even after apparent resolution of the acute infection and be mindful of the therapeutic challenges that we might face while managing such patients.

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Management of COVID-19 myopericarditis with reversal of cardiac dysfunction after blunting of cytokine storm: a case report

Cited by 16 publications

References 14 publications

In Vitro Assessment of the Antiviral Activity of Ketotifen, Indomethacin and Naproxen, Alone and in Combination, against SARS-CoV-2

In Vitro Assessment of the Antiviral Activity of Ketotifen, Indomethacin and Naproxen, Alone and in Combination, against SARS-CoV-2

The cardiac effects of SARS-CoV2: COVID-19 special issue

Challenges in Managing Pericardial Disease Related to Post Viral Syndrome After COVID-19 Infection

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