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Noninvasive Assessment of Cardiac Abnormalities in Experimental Autoimmune Myocarditis by Magnetic Resonance Microscopy Imaging in the Mouse
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Features of Myocarditis: Morphological Differential Diagnosis in Post-COVID-19 Children

Vadim Karev1,2, Anastasia Ya Starshinova3, Anzhela Glushkova4

  • 1Children's Clinical Research Center for Infectious Diseases, St. Petersburg 194100, Russia.

Diagnostics (Basel, Switzerland)
|August 12, 2023
PubMed

Insights

Diagnosing myocarditis, especially from SARS-CoV-2 infection, requires reconsidering morphological criteria beyond PCR. Histopathological changes offer key markers for this cardiovascular inflammation in children and adults.

Area of Science:

  • Cardiology
  • Pathology
  • Infectious Diseases

Background:

  • Myocarditis involves cardiomyocyte dysfunction, inflammation, and fibrosis, posing a global health challenge.
  • Late diagnosis of myocarditis is a significant issue, exacerbated by novel coronavirus infections like COVID-19.
  • Understanding viral etiologies, including SARS-CoV-2, is crucial for accurate myocarditis diagnosis.

Purpose of the Study:

  • To differentiate myocarditis of viral etiology, specifically SARS-CoV-2, using instrumental and pathomorphological findings.
  • To review and analyze diagnostic criteria for myocarditis associated with viral infections.

Main Methods:

  • Systematic review of publications from December 2019 to May 2023.
  • Searched major international databases (Medline, PubMed, Scopus).
  • Keywords included: myocarditis, children, cardiovascular inflammation, COVID-19, SARS-CoV-2, and differential diagnosis.

Main Results:

  • No definitive morphological criteria for SARS-CoV-2-associated myocarditis were identified.
  • Key histopathological markers for SARS-CoV-2 infection include virus-associated degeneration, apoptosis, cardiomyocyte necrosis, hyperemia, edema, and capillary endothelial dysfunction.
  • These findings highlight specific changes in myocardial tissue during SARS-CoV-2 infection.

Conclusions:

  • Relying solely on PCR for viral RNA is insufficient for diagnosing SARS-CoV-2 myocarditis; morphological criteria need re-evaluation.
  • Similar diagnostic challenges exist for myocarditis linked to other viral infections.
  • An etiological diagnosis requires a comprehensive approach: virus exposure confirmation, clinical symptoms, imaging (MRI/CT), and morphological data.

Keywords:
SARS-CoV-2 infectionheart transplantationimmunohistochemical and ultrastructural myocardial studiesvirus transmission

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