tetano
Editor, Senior Moderator
ESC Heart Fail
. 2023 Jan 24.
doi: 10.1002/ehf2.14295. Online ahead of print.
COVID-19-associated myocardial injury: A case report
Tomonori Tadokoro[SUP] 1 [/SUP], Keiko Ohta-Ogo[SUP] 2 [/SUP], Yoshihiko Ikeda[SUP] 2 [/SUP], Masaya Sugiyama[SUP] 3 [/SUP], Harutaka Katano[SUP] 4 [/SUP], Kinta Hatakeyama[SUP] 2 [/SUP], Masanori Matsumoto[SUP] 5 [/SUP], Hideki Tashiro[SUP] 1 [/SUP]
Affiliations
Abstract
Coronavirus disease 2019 (COVID-19) is often accompanied by pneumonia and can be fatal. We report a case of COVID-19-associated myocardial injury mimicking fulminant myocarditis. Endomyocardial biopsy revealed numerous von Willebrand factor-rich microthrombi with small myocardial necrotic areas, complement deposits in small vessels/microthrombi, and macrophage-predominant interstitial infiltration. These findings, distinct from those of typical lymphocytic myocarditis, show diffuse endothelial injury, complement activation, and activated macrophages as characteristic features of COVID-19-associated pathogenesis. Dysregulated serum cytokine profiles predicting severe/critical COVID-19-associated myocardial injury were also determined. This case emphasizes the occurrence of fatal cardiac manifestation with microthrombotic injury in the early stage of COVID-19.
Keywords: COVID-19; Complement; Endothelial injury; Macrophage infiltration; Microthrombi; Myocardial injury.
. 2023 Jan 24.
doi: 10.1002/ehf2.14295. Online ahead of print.
COVID-19-associated myocardial injury: A case report
Tomonori Tadokoro[SUP] 1 [/SUP], Keiko Ohta-Ogo[SUP] 2 [/SUP], Yoshihiko Ikeda[SUP] 2 [/SUP], Masaya Sugiyama[SUP] 3 [/SUP], Harutaka Katano[SUP] 4 [/SUP], Kinta Hatakeyama[SUP] 2 [/SUP], Masanori Matsumoto[SUP] 5 [/SUP], Hideki Tashiro[SUP] 1 [/SUP]
Affiliations
- PMID: 36691883
- DOI: 10.1002/ehf2.14295
Abstract
Coronavirus disease 2019 (COVID-19) is often accompanied by pneumonia and can be fatal. We report a case of COVID-19-associated myocardial injury mimicking fulminant myocarditis. Endomyocardial biopsy revealed numerous von Willebrand factor-rich microthrombi with small myocardial necrotic areas, complement deposits in small vessels/microthrombi, and macrophage-predominant interstitial infiltration. These findings, distinct from those of typical lymphocytic myocarditis, show diffuse endothelial injury, complement activation, and activated macrophages as characteristic features of COVID-19-associated pathogenesis. Dysregulated serum cytokine profiles predicting severe/critical COVID-19-associated myocardial injury were also determined. This case emphasizes the occurrence of fatal cardiac manifestation with microthrombotic injury in the early stage of COVID-19.
Keywords: COVID-19; Complement; Endothelial injury; Macrophage infiltration; Microthrombi; Myocardial injury.