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MiR-21 and Tocilizumab interactions improve COVID-19 myocarditis outcomes

Amir Hossein Heydari1, Saeid Ghaffari2, Zahra Khani2

  • 1School of Medicine, Zanjan University of Medical Science, Karmandan District, Mahdavi, Zanjan, Zanjan Province, Iran.

Therapeutic Advances in Cardiovascular Disease
|July 10, 2023
PubMed
Abstract

Insights

Tocilizumab (TCZ) improved cardiac function and reduced mortality in COVID-19 myocarditis patients within 7 days. Remdesivir (RMS) showed limited efficacy and higher mortality, while TCZ decreased miR-21 expression, indicating its protective role.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Pharmacology

Background:

  • Myocarditis is a severe complication of COVID-19, posing significant mortality and morbidity risks.
  • Recent scientific focus has intensified on understanding and managing COVID-19-associated myocarditis.

Purpose of the Study:

  • To evaluate the therapeutic effects of Remdesivir (RMS) and Tocilizumab (TCZ) in patients with COVID-19 myocarditis.
  • To compare the efficacy of TCZ and RMS in improving cardiac function and survival rates.

Main Methods:

  • An observational cohort study design was employed.
  • Patients diagnosed with COVID-19 myocarditis were categorized into three treatment groups: TCZ, RMS, and Dexamethasone.
  • Treatment outcomes were assessed after a 7-day treatment period.

Main Results:

  • Tocilizumab (TCZ) significantly improved ejection fraction within 7 days, though with limited overall efficacy.
  • Remdesivir (RMS) demonstrated improvements in inflammatory markers but led to worsened cardiac function and higher mortality compared to TCZ.
  • TCZ treatment was associated with a reduction in miR-21 expression, suggesting a cardioprotective mechanism.

Conclusions:

  • Early administration of Tocilizumab (TCZ) in COVID-19 myocarditis patients can preserve cardiac function and decrease mortality.
  • The miR-21 expression level is a key determinant of treatment response and patient outcomes in COVID-19 myocarditis.
Keywords:
COVID-19RemdesivirSARS-CoVTocilizumabmiR-21-pmyocarditis

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