Abstract:Aim To study clinical features of myoendocarditis and its possible mechanisms, including persistence of SARS-Cov-2 in the myocardium, in the long-term period following COVID-19.Material and methods This cohort, prospective study included 15 patients aged 47.8±13.4 years (8 men) with post-COVID myocarditis. The COVID-19 diagnosis was confirmed for all patients. Median time to seeking medical care after COVID-19 was 4 [3; 7] months. The diagnosis of myocarditis was confirmed by magnetic resonance imaging (… Show more
“…The detected changes among the symptomatic patients with carried COVID-19 definitely need treatment. Taking into account, that right departments of the heart have been mostly affected the with the formation of chronic pulmonary heart disease, it is advisable to use drugs of neurohumoral blockade of the renin-angiotensinaldosterone system [15,16]. As the patients have been already taking ACE inhibitors and beta-blockers before the treatment, it was advisable to add a mineralocorticoid receptor antagonist, spironolactone, which blocks the biological effects of aldosterone: sodium and water retention, potassium and magnesium loss, the development of generalized fibrosis, heart and vascular remodeling [17,18].…”
Abstract. Purpose of the work: to study the indicators characterizing heart lesions in elderly patients who had carried COVID-19.
Materials and methods: 86 patients older than 60 years old, were examined, of whom 56 (32 women and 24 men) who have carried COVID-19 between 3 and 6 months before the study, and 30 patients (12 men and 18 women) who did not have COVID - 19 in the anamnesis. The patients have been examined clinically, electro and echocardiography have been performed.
The results. Elderly patients during the post-covid period have complaints of shortness of breath, pain in the heart, swelling, coughing, weakness, which are more stable and intense than before the infection. Patients who have carried COVID-19 demonstrate the signs of a chronic pulmonary heart disease: increase in the size of a right ventricle and decrease of its contractile ability, increase in pressure in a pulmonary artery. Signs of a statistically significant moderate decrease of the contractility in the left ventricular were also identified.
Conclusions. The statistically significant changes in the right departments of the heart among the patients with carried COVID-19 with persistent symptoms after infection were defined. Patients who have carried COVID-19 but have no symptoms did not differ statistically from the control group.
Key words: COVID-19, old age, post- COVID period, right departments of the heart.
“…The detected changes among the symptomatic patients with carried COVID-19 definitely need treatment. Taking into account, that right departments of the heart have been mostly affected the with the formation of chronic pulmonary heart disease, it is advisable to use drugs of neurohumoral blockade of the renin-angiotensinaldosterone system [15,16]. As the patients have been already taking ACE inhibitors and beta-blockers before the treatment, it was advisable to add a mineralocorticoid receptor antagonist, spironolactone, which blocks the biological effects of aldosterone: sodium and water retention, potassium and magnesium loss, the development of generalized fibrosis, heart and vascular remodeling [17,18].…”
Abstract. Purpose of the work: to study the indicators characterizing heart lesions in elderly patients who had carried COVID-19.
Materials and methods: 86 patients older than 60 years old, were examined, of whom 56 (32 women and 24 men) who have carried COVID-19 between 3 and 6 months before the study, and 30 patients (12 men and 18 women) who did not have COVID - 19 in the anamnesis. The patients have been examined clinically, electro and echocardiography have been performed.
The results. Elderly patients during the post-covid period have complaints of shortness of breath, pain in the heart, swelling, coughing, weakness, which are more stable and intense than before the infection. Patients who have carried COVID-19 demonstrate the signs of a chronic pulmonary heart disease: increase in the size of a right ventricle and decrease of its contractile ability, increase in pressure in a pulmonary artery. Signs of a statistically significant moderate decrease of the contractility in the left ventricular were also identified.
Conclusions. The statistically significant changes in the right departments of the heart among the patients with carried COVID-19 with persistent symptoms after infection were defined. Patients who have carried COVID-19 but have no symptoms did not differ statistically from the control group.
Key words: COVID-19, old age, post- COVID period, right departments of the heart.
“…Heparin may be a defining factor in the evolution and prognosis of the disease in patients with COVID-related myocarditis. [ 21 ]. The fact that the binding of heparin to spike glycoprotein inhibits SARS-CoV2 infection has led to the proposal of heparin as a drug with antiviral activity [ 22 ].…”
Section: Treatmentmentioning
confidence: 99%
“…Endocarditis can manifest as infectious or nonbacterial thromboendocarditis. The authors propose to study the possibility of using corticosteroids and anticoagulants in the treatment of post-COVID myoendocarditis [ 21 ].…”
The coronavirus disease of 2019 (COVID-19) has been a cause of significant morbidity and mortality worldwide. Among the short- and long-term consequences of COVID-19, myocarditis is a disease to be taken into consideration. Myocarditis, in general, is related to a poor prognosis. However, the epidemiology and prognosis of myocarditis related to COVID-19 are currently unknown. While vaccination against COVID-19 is of great benefit at a public health level, the risk of myocarditis should be considered in the context of the global benefits of vaccination. In this narrative review, we will summarize the etiopathogenic bases, the epidemiology, the clinical manifestations, the course, diagnosis, prognosis, and the treatment of myocarditis related to SARS-CoV-2, as well as myocarditis secondary to mRNA vaccines.
“…At the same time, this period after acute COVID-19 vary from several months to six months or even more. [2][3][4]. Cardiovascular manifestation in COVID-19 is diverse: acute myocardial infarction, myocarditis, stress-induced cardiomyopathy, nonischemic cardiomyopathy, coronary spasm [5][6][7].…”
The article is devoted to the actual problem in the case of ongoing COVID-19 pandemic -the clinical and morphological characteristics of СOVID-19 associated myocarditis in conditions of non-widespread of this topic.The aim of the study is to study the clinical and morphological features of COVID-19 associated heart damage in deceased patients. The study included data from medical cards of inpatients of Almaty City cardiological center, as well as postmortem data of 12 patients (9 men and 3 women, average of age 65,6±13,8, 51-80 years), dead patients with a diagnosis of atherosclerosis-associated diseases. Pathological anatomical autopsy was performed at the Central Pathological Anatomical Department of Federal Health Institution "Central Medical and Sanitary Unit No. 1 of the Federal Medical and Biological Agency Hospital №1 Russia. Extrapolating data from the pathomorphological study of deceased patients, who had a history of coronavirus infection and died from circulatory system diseases, on autopsy it was found that SARS-Cov-2 infection led to the development of subacute/chronic myocarditis. Its clinical manifestations develop within 4-6 months or more than a year after acute COVID-19 in the form of myocardial infarction or progressive heart failure. The researchers also emphasize the extreme importance of performing autopsy studies of any nosology in combination with COVID-19, for subsequent clinical and morphological analysis, which provide invaluable opportunities to summarize each morphological manifestation of this infection to be further compared to clinical manifestations.Thus, at present, any unclear myocardial dysfunction requires serodiagnosis of a new coronavirus infection. SARS-Cov-2 infection can cause chronic nonbacterial lymphocytic thromboendocarditis with an autoimmune mechanism; as well as its combination with lymphocytic myocarditis. Research in this field still needs to be continued.
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