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Int. J. Clin. Pract. · Nov 2021
Case ReportsMyocarditis associated with Covid-19 disease: A systematic review of published case reports and case series.
- Sawai Singh Rathore, Gianpier Alonzo Rojas, Manush Sondhi, Suveenkrishna Pothuru, Reshma Pydi, Neeraj Kancherla, Romil Singh, Noman Khurshid Ahmed, Jill Shah, Sohaib Tousif, Unaiza Tariq Baloch, and Qingqing Wen.
- Internal Medicine, Dr. Sampurnanand Medical College, Jodhpur, India.
- Int. J. Clin. Pract. 2021 Nov 1; 75 (11): e14470.
BackgroundCovid-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.ObjectiveThis systematic review article aimed to compile and illustrate clinical characteristics, diagnostic findings, management, and outcomes manifesting in myocarditis linked with Covid-19.MethodsA 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.ResultsData 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.ConclusionBecause 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.© 2021 John Wiley & Sons Ltd.
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