An ‘asymptomatic’ driver with COVID-19: atypical suspected myocarditis by SARS-CoV-2

Yuan, Wei-Feng; Tang, Xi; Zhao, Xinying

doi:10.21037/cdt.2020.03.08

Cited by 16 publications

(19 citation statements)

References 4 publications

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“…Fourteen records comprising a total of fourteen cases that report myocarditis/myopericarditis believed to have occurred secondary to COVID-19 infection were identified from December 1st 2019 to June 30th 2020 [ [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] ]. There was a male predominance (58%), with the median age of the cases described being 50.4 years.…”

Section: Resultsmentioning

confidence: 99%

Systematic Review of COVID-19 Related Myocarditis: Insights on Management and Outcome

Sawalha

Abozenah

Kadado

et al. 2021

Cardiovascular Revascularization Medicine

199

211

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Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also referred to as COVID-19, was declared a pandemic by the World Health Organization in March 2020. The manifestations of COVID-19 are widely variable and range from asymptomatic infection to multi-organ failure and death. Like other viral illnesses, acute myocarditis has been reported to be associated with COVID-19 infection. However, guidelines for the diagnosis of COVID-19 myocarditis have not been established. Methods Using a combination of search terms in the PubMed/Medline, Ovid Medline and the Cochrane Library databases and manual searches on Google Scholar and the bibliographies of articles identified, we reviewed all cases reported in the English language citing myocarditis associated with COVID-19 infection. Results Fourteen records comprising a total of fourteen cases that report myocarditis/myopericarditis secondary to COVID-19 infection were identified. There was a male predominance (58%), with the median age of the cases described being 50.4 years. The majority of patients did not have a previously identified comorbid condition (50%), but of those with a past medical history, hypertension was most prevalent (33%). Electrocardiogram findings were variable, and troponin was elevated in 91% of cases. Echocardiography was performed in 83% of cases reduced function was identified in 60%. Endotracheal intubation was performed in the majority of cases. Glucocorticoids were most commonly used in treatment of myocarditis (58%). Majority of patients survived to discharge (81%) and 85% of those that received steroids survived to discharge. Conclusion Guidelines for diagnosis and management of COVID-19 myocarditis have not been established and our knowledge on management is rapidly changing. The use of glucocorticoids and other agents including IL-6 inhibitors, IVIG and colchicine in COVID-19 myocarditis is debatable. In our review, there appears to be favorable outcomes related to myocarditis treated with steroid therapy. However, until larger scale studies are conducted, treatment approaches have to be made on an individualized case-by-case basis.

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Section: Resultsmentioning

confidence: 99%

Systematic Review of COVID-19 Related Myocarditis: Insights on Management and Outcome

Sawalha

Abozenah

Kadado

et al. 2021

Cardiovascular Revascularization Medicine

199

211

View full text Add to dashboard Cite

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“…1 ). There were 24 case reports, 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 5 case series 29 , 30 , 31 , 32 , 33 and 2 cohort studies, 34 , 35 on a total of 51 cases of myocarditis and SARS-CoV-2 infection. The studies were of poor to fair quality due to the high risk of selection bias in case reports and small case series (Supplementary Table 1).…”

Section: Resultsmentioning

confidence: 99%

“…In the 51 patients, 12 were confirmed cases of myocarditis diagnosed by histopathological evidence or CMR features fulfilling the Lake Louise consensus criteria ( Table 2 ). 5 , 6 , 7 , 9 , 13 , 14 , 15 , 21 , 22 , 23 , 24 , 25 , 36 The remaining 39 were possible cases where authors reported a diagnosis of myocarditis, with or without supporting serological, electrocardiogram (ECG) and echocardiographic features. The age of confirmed cases was 39 (28.5–60) years, and 9 (75%) were male.…”

Section: Resultsmentioning

confidence: 99%

Coronavirus-induced myocarditis: A meta-summary of cases

et al. 2020

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Those with a severe and depressed LV function developed cardiogenic shock, thereby having a worse prognosis 4,6 . Although CMR was not performed in all cases because of prolonged acquisition time and the fact that COVID-19 infection is highly contagious, it showed myocardial edema and sub-epicardial late gadolinium enhancement in some parts of the LV [7][8][9][10][11][12]16 . Interestingly, no EMB was performed to confirm the diagnosis in all patients even though it is considered a gold standard.…”

Section: Imaging Featuresmentioning

confidence: 99%

COVID-19 and acute myocarditis: current literature review and diagnostic challenges

Çınar

Hayıroğlu

Çiçek

et al. 2020

Rev. Assoc. Med. Bras.

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SUMMARY INTRODUCTION In the current literature, there has been an upsurge of cases of COVID-19-induced acute myocarditis. In this case-based review, we aimed to describe the clinical characteristics, imaging findings, and in-hospital course of acute myocarditis. In addition, the limitations of the myocarditis diagnosis were discussed since only fulminant myocarditis cases have been mentioned in the current literature. METHODS We performed a review of the literature of all patients who were diagnosed with COVID-19-induced acute myocarditis using the databases of PubMed, Embase, and the Cochrane. RESULTS 16 case reports were found to be related to COVID-19-induced acute myocarditis. We observed that the ECG findings in most of the COVID-19 patients were non-specific, including diffuse ST-segment elevation, non-specific intraventricular conduction delay, sinus tachycardia, and inverted T-waves in anterior leads. Echocardiographic findings of COVID-19-induced acute myocarditis patients ranged from preserved left ventricular ejection fraction (LVEF) without segmental abnormalities to reduced LVEF with global hypokinesia. Interestingly, a few patients with COVID-19-induced acute fulminant myocarditis were steroid-responsive and had an amelioration with glucocorticoid and immunoglobulin therapy. CONCLUSION Despite the COVID-19 pandemic worldwide, a limited number of cases has been shared in the current literature. There are a lot of difficulties in the differential diagnosis of acute myocarditis in the context of COVID-19.

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An ‘asymptomatic’ driver with COVID-19: atypical suspected myocarditis by SARS-CoV-2

Cited by 16 publications

References 4 publications

Systematic Review of COVID-19 Related Myocarditis: Insights on Management and Outcome

Systematic Review of COVID-19 Related Myocarditis: Insights on Management and Outcome

Coronavirus-induced myocarditis: A meta-summary of cases

COVID-19 and acute myocarditis: current literature review and diagnostic challenges

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