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Acute Myocarditis Related to COVID-19: Comparison to SARS and MERS

Angeliki M Chasouraki1, Odyssefs A Violetis1, Mahmoud Abdelrasoul1

  • 1Internal Medicine Clinic, Pammakaristos Hospital of Divine Providence (Reference Centre for COVID-19 infection), Iakovaton 43, 11144 Athens, Greece.

SN Comprehensive Clinical Medicine
|November 25, 2020
PubMed

Insights

Severe COVID-19 infection can impact the heart, with myocardial injury observed in up to 30% of patients. This review examines potential myocarditis cases linked to SARS-CoV-2, comparing them with prior coronavirus outbreaks.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Virology

Background:

  • Previous outbreaks of SARS and MERS demonstrated myocardial involvement.
  • SARS-CoV-2 (COVID-19) infection presents a spectrum of severity, from asymptomatic to critical multi-system disease.
  • Cardiac complications, particularly myocardial injury, are increasingly recognized in severe COVID-19.

Purpose of the Study:

  • To review and analyze reported cases of myocarditis associated with SARS-CoV-2 infection.
  • To compare the clinical presentation, treatment, and prognosis of COVID-19-related myocarditis with findings from SARS and MERS outbreaks.
  • To assess the evidence for direct myocardial involvement in SARS-CoV-2 infection.

Main Methods:

  • Literature review of cases describing myocarditis in COVID-19 patients.
  • Comparative analysis with existing literature on myocardial involvement in SARS and MERS.
  • Evaluation of clinical data, diagnostic markers (e.g., myocardial enzymes), and outcomes.

Main Results:

  • Myocardial injury, indicated by elevated cardiac enzymes, affects up to 30% of COVID-19 patients, correlating with poorer prognosis.
  • Evidence for direct SARS-CoV-2 myocardial involvement in myocarditis cases is variable.
  • Comparison with SARS and MERS suggests potential similarities in cardiac manifestations.

Conclusions:

  • Myocardial involvement is a significant concern in severe COVID-19.
  • Further research is needed to elucidate the mechanisms and clinical implications of SARS-CoV-2-induced myocarditis.
  • Understanding cardiac involvement in COVID-19 is crucial for patient management and prognosis, drawing parallels from previous coronavirus studies.
Keywords:
COVID-19CorticosteroidsMyocardial injuryMyocarditisTreatmentTroponin

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