SARS-CoV-2 is localized in cardiomyocytes: a postmortem biopsy case

Area of Science:

• Cardiology
• Virology
• Pathology

Background:

• Severe COVID-19 can lead to critical illness and multi-organ dysfunction.
• Cardiac complications, including myocardial injury, are increasingly recognized in severe COVID-19.
• Takotsubo cardiomyopathy is a stress-induced condition that can mimic myocardial infarction.

Observation:

• A 72-year-old patient with COVID-19-induced acute respiratory distress syndrome developed shock and Takotsubo cardiomyopathy.
• Electrocardiogram showed ST elevation, and echocardiography revealed severe left ventricular dysfunction.
• Post-mortem examination detected SARS-CoV-2 antigen in cardiomyocytes and viral RNA in heart tissue.

Findings:

• The patient's presentation and cardiac dysfunction were consistent with Takotsubo cardiomyopathy.
• Immunostaining confirmed SARS-CoV-2 antigen presence within myocardial cells.
• Molecular detection of SARS-CoV-2 RNA in cardiac tissue provides evidence of viral presence.

Implications:

• These findings suggest a potential direct causal link between SARS-CoV-2 infection and cardiomyocyte damage.
• Further research is warranted to elucidate the mechanisms of SARS-CoV-2-induced cardiomyopathy.
• Understanding this link may inform therapeutic strategies for cardiac complications in COVID-19 patients.