Importance: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be documented in various tissues, but the frequency of cardiac involvement as well as possible consequences are unknown. Objective: To evaluate the presence of SARS-CoV-2 in the myocardial tissue from autopsy cases and to document a possible cardiac response to that infection. Design, Setting, and Participants: This cohort study used data from consecutive autopsy cases from Germany between April 8 and April 18, 2020. All patients had tested positive for SARS-CoV-2 in pharyngeal swab tests. Exposures: Patients who died of coronavirus disease 2019. Main Outcomes and Measures: Incidence of SARS-CoV-2 positivity in cardiac tissue as well as CD3+, CD45+, and CD68+ cells in the myocardium and gene expression of tumor necrosis growth factor α, interferon γ, chemokine ligand 5, as well as interleukin-6, -8, and -18. Results: Cardiac tissue from 39 consecutive autopsy cases were included. The median (interquartile range) age of patients was 85 (78-89) years, and 23 (59.0%) were women. SARS-CoV-2 could be documented in 24 of 39 patients (61.5%). Viral load above 1000 copies per μg RNA could be documented in 16 of 39 patients (41.0%). A cytokine response panel consisting of 6 proinflammatory genes was increased in those 16 patients compared with 15 patients without any SARS-CoV-2 in the heart. Comparison of 15 patients without cardiac infection with 16 patients with more than 1000 copies revealed no inflammatory cell infiltrates or differences in leukocyte numbers per high power field. Conclusions and Relevance: In this analysis of autopsy cases, viral presence within the myocardium could be documented. While a response to this infection could be reported in cases with higher virus load vs no virus infection, this was not associated with an influx of inflammatory cells. Future investigations should focus on evaluating the long-term consequences of this cardiac involvement.
Importance: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be documented in various tissues, but the frequency of cardiac involvement as well as possible consequences are unknown. Objective: To evaluate the presence of SARS-CoV-2 in the myocardial tissue from autopsy cases and to document a possible cardiac response to that infection. Design, Setting, and Participants: This cohort study used data from consecutive autopsy cases from Germany between April 8 and April 18, 2020. All patients had tested positive for SARS-CoV-2 in pharyngeal swab tests. Exposures: Patients who died of coronavirus disease 2019. Main Outcomes and Measures: Incidence of SARS-CoV-2 positivity in cardiac tissue as well as CD3+, CD45+, and CD68+ cells in the myocardium and gene expression of tumor necrosis growth factor α, interferon γ, chemokine ligand 5, as well as interleukin-6, -8, and -18. Results: Cardiac tissue from 39 consecutive autopsy cases were included. The median (interquartile range) age of patients was 85 (78-89) years, and 23 (59.0%) were women. SARS-CoV-2 could be documented in 24 of 39 patients (61.5%). Viral load above 1000 copies per μg RNA could be documented in 16 of 39 patients (41.0%). A cytokine response panel consisting of 6 proinflammatory genes was increased in those 16 patients compared with 15 patients without any SARS-CoV-2 in the heart. Comparison of 15 patients without cardiac infection with 16 patients with more than 1000 copies revealed no inflammatory cell infiltrates or differences in leukocyte numbers per high power field. Conclusions and Relevance: In this analysis of autopsy cases, viral presence within the myocardium could be documented. While a response to this infection could be reported in cases with higher virus load vs no virus infection, this was not associated with an influx of inflammatory cells. Future investigations should focus on evaluating the long-term consequences of this cardiac involvement.
Authors: Tau S Hartikainen; Nils Arne Sörensen; Paul Michael Haller; Alina Goßling; Jonas Lehmacher; Tanja Zeller; Stefan Blankenberg; Dirk Westermann; Johannes Tobias Neumann Journal: Eur Heart J Date: 2020-06-14 Impact factor: 29.983
Authors: Carolin Edler; Ann Sophie Schröder; Martin Aepfelbacher; Antonia Fitzek; Axel Heinemann; Fabian Heinrich; Anke Klein; Felicia Langenwalder; Marc Lütgehetmann; Kira Meißner; Klaus Püschel; Julia Schädler; Stefan Steurer; Herbert Mushumba; Jan-Peter Sperhake Journal: Int J Legal Med Date: 2020-06-04 Impact factor: 2.686
Authors: Victor M Corman; Olfert Landt; Marco Kaiser; Richard Molenkamp; Adam Meijer; Daniel Kw Chu; Tobias Bleicker; Sebastian Brünink; Julia Schneider; Marie Luisa Schmidt; Daphne Gjc Mulders; Bart L Haagmans; Bas van der Veer; Sharon van den Brink; Lisa Wijsman; Gabriel Goderski; Jean-Louis Romette; Joanna Ellis; Maria Zambon; Malik Peiris; Herman Goossens; Chantal Reusken; Marion Pg Koopmans; Christian Drosten Journal: Euro Surveill Date: 2020-01
Authors: Tomasz J Guzik; Saidi A Mohiddin; Anthony Dimarco; Vimal Patel; Kostas Savvatis; Federica M Marelli-Berg; Meena S Madhur; Maciej Tomaszewski; Pasquale Maffia; Fulvio D'Acquisto; Stuart A Nicklin; Ali J Marian; Ryszard Nosalski; Eleanor C Murray; Bartlomiej Guzik; Colin Berry; Rhian M Touyz; Reinhold Kreutz; Dao Wen Wang; David Bhella; Orlando Sagliocco; Filippo Crea; Emma C Thomson; Iain B McInnes Journal: Cardiovasc Res Date: 2020-08-01 Impact factor: 10.787
Authors: Anuradha Lala; Kipp W Johnson; James L Januzzi; Adam J Russak; Ishan Paranjpe; Felix Richter; Shan Zhao; Sulaiman Somani; Tielman Van Vleck; Akhil Vaid; Fayzan Chaudhry; Jessica K De Freitas; Zahi A Fayad; Sean P Pinney; Matthew Levin; Alexander Charney; Emilia Bagiella; Jagat Narula; Benjamin S Glicksberg; Girish Nadkarni; Donna M Mancini; Valentin Fuster Journal: J Am Coll Cardiol Date: 2020-06-08 Impact factor: 24.094
Authors: G Y Oudit; Z Kassiri; C Jiang; P P Liu; S M Poutanen; J M Penninger; J Butany Journal: Eur J Clin Invest Date: 2009-05-06 Impact factor: 4.686
Authors: Simone Cristina Soares Brandão; Júlia de Oliveira Xavier Ramos; Gustavo Freitas Alves de Arruda; Emmanuelle Tenório Albuquerque Madruga Godoi; Lara Cristiane Terra Ferreira Carreira; Rafael Willain Lopes; Gabriel Blacher Grossman; Ronaldo de Souza Leão Lima Journal: Am J Nucl Med Mol Imaging Date: 2020-12-15
Authors: Ani Nalbandian; Kartik Sehgal; Aakriti Gupta; Mahesh V Madhavan; Claire McGroder; Jacob S Stevens; Joshua R Cook; Anna S Nordvig; Daniel Shalev; Tejasav S Sehrawat; Neha Ahluwalia; Behnood Bikdeli; Donald Dietz; Caroline Der-Nigoghossian; Nadia Liyanage-Don; Gregg F Rosner; Elana J Bernstein; Sumit Mohan; Akinpelumi A Beckley; David S Seres; Toni K Choueiri; Nir Uriel; John C Ausiello; Domenico Accili; Daniel E Freedberg; Matthew Baldwin; Allan Schwartz; Daniel Brodie; Christine Kim Garcia; Mitchell S V Elkind; Jean M Connors; John P Bilezikian; Donald W Landry; Elaine Y Wan Journal: Nat Med Date: 2021-03-22 Impact factor: 53.440
Authors: Yi-Han Lin; Maryann P Platt; Ryan P Gilley; David Brown; Peter H Dube; Yanbao Yu; Norberto Gonzalez-Juarbe Journal: Circ Res Date: 2021-01-27 Impact factor: 17.367