Sawai Singh Rathore1, Gianpier Alonzo Rojas2,3, Manush Sondhi4, Suveenkrishna Pothuru5, Reshma Pydi6, Neeraj Kancherla6, Romil Singh7, Noman Khurshid Ahmed8, Jill Shah9, Sohaib Tousif10, Unaiza Tariq Baloch11, Qingqing Wen12. 1. Internal Medicine, Dr. Sampurnanand Medical College, Jodhpur, India. 2. Internal Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru. 3. Scientific society of medical students, Lima, Perú. 4. Internal Medicine, Kasturba Medical College, Manipal, India. 5. Internal Medicine, Ascension Via Christi Hospital, Manhattan, KS, USA. 6. Internal Medicine, Andhra Medical College, Visakhapatnam, India. 7. Department of Critical Care, Mayo Clinic, Rochester, MN, USA. 8. Internal Medicine, Dow Medical College, Karachi, Pakistan. 9. Internal Medicine, Tambov State University named after G.R. Derzhavin, Tambov, Russia. 10. Internal Medicine, Ziauddin Medical University, Karachi, Pakistan. 11. Internal Medicine, Aga Khan University Hospital, Karachi, Pakistan. 12. Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
Abstract
BACKGROUND: Covid-19 is an extremely contagious illness caused by the severe acute respiratory syndrome (SARS-CoV-2) virus. The cardiac involvement in such a public health emergency disease has not been well studied and a conflicting evidence exists on this issue. OBJECTIVE: This systematic review article aimed to compile and illustrate clinical characteristics, diagnostic findings, management, and outcomes manifesting in myocarditis linked with Covid-19. METHODS: A literature search was accomplished for published eligible articles with MEDLINE/PubMed and Embase databases. All eligible case reports and case series were included from around the world without any language restrictions. For this review, inclusion criteria were laboratory-confirmed SARS-CoV-2 infection cases reporting a diagnosis of acute myocarditis. RESULTS: Data from 41 studies describing myocarditis in 42 Covid-19 patients was obtained. The median age of these patients was 43.4 years, with 71.4% of them being men. Fever was the most prevalent presenting symptoms seen in 57% of patients. Hypertension was the most pervasive comorbidity accompanying these patients. Cardiac biomarkers troponin and brain natriuretic peptide (BNP) were raised in almost 90% and 87% of patients, respectively. Electrocardiogram findings were nonspecific and included ST-segment and T-wave changes. Echocardiogram commonly showed left ventricular systolic dysfunction with increased heart size. Cardiac magnetic resonance imaging (CMRI) exhibited myocardial edema and injury. The most prevalent histopathological feature appreciated was diffuse lymphocytic inflammatory infiltrates. Antivirals and corticosteroids were the most frequently used medications. About 38% of patients also needed vasopressor assistance. Out of 42 patients, 67% recovered, and eight died. CONCLUSION: Because of the risk of a sudden worsening of patients conditions and myocarditis association with considerable mortality and morbidity, a knowledge of this cardiac complication of Covid-19 disease is crucial for healthcare professionals.
BACKGROUND:Covid-19 is an extremely contagious illness caused by the severe acute respiratory syndrome (SARS-CoV-2) virus. The cardiac involvement in such a public health emergency disease has not been well studied and a conflicting evidence exists on this issue. OBJECTIVE: This systematic review article aimed to compile and illustrate clinical characteristics, diagnostic findings, management, and outcomes manifesting in myocarditis linked with Covid-19. METHODS: A literature search was accomplished for published eligible articles with MEDLINE/PubMed and Embase databases. All eligible case reports and case series were included from around the world without any language restrictions. For this review, inclusion criteria were laboratory-confirmed SARS-CoV-2 infection cases reporting a diagnosis of acute myocarditis. RESULTS: Data from 41 studies describing myocarditis in 42 Covid-19patients was obtained. The median age of these patients was 43.4 years, with 71.4% of them being men. Fever was the most prevalent presenting symptoms seen in 57% of patients. Hypertension was the most pervasive comorbidity accompanying these patients. Cardiac biomarkers troponin and brain natriuretic peptide (BNP) were raised in almost 90% and 87% of patients, respectively. Electrocardiogram findings were nonspecific and included ST-segment and T-wave changes. Echocardiogram commonly showed left ventricular systolic dysfunction with increased heart size. Cardiac magnetic resonance imaging (CMRI) exhibited myocardial edema and injury. The most prevalent histopathological feature appreciated was diffuse lymphocytic inflammatory infiltrates. Antivirals and corticosteroids were the most frequently used medications. About 38% of patients also needed vasopressor assistance. Out of 42 patients, 67% recovered, and eight died. CONCLUSION: Because of the risk of a sudden worsening of patients conditions and myocarditis association with considerable mortality and morbidity, a knowledge of this cardiac complication of Covid-19 disease is crucial for healthcare professionals.
Authors: Ty J Gluckman; Nicole M Bhave; Larry A Allen; Eugene H Chung; Erica S Spatz; Enrico Ammirati; Aaron L Baggish; Biykem Bozkurt; William K Cornwell; Kimberly G Harmon; Jonathan H Kim; Anuradha Lala; Benjamin D Levine; Matthew W Martinez; Oyere Onuma; Dermot Phelan; Valentina O Puntmann; Saurabh Rajpal; Pam R Taub; Amanda K Verma Journal: J Am Coll Cardiol Date: 2022-03-16 Impact factor: 27.203
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