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    Pathological Evidence for SARS-CoV-2 as a Cause of Myocarditis: JACC Review Topic of the Week

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    Author
    Kawakami, Rika
    Sakamoto, Atsushi
    Kawai, Kenji
    Gianatti, Andrea
    Pellegrini, Dario
    Nasr, Ahmed
    Kutys, Bob
    Guo, Liang
    Cornelissen, Anne
    Mori, Masayuki
    Sato, Yu
    Pescetelli, Irene
    Brivio, Matteo
    Romero, Maria
    Guagliumi, Giulio
    Virmani, Renu
    Finn, Aloke V
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    Date
    2021-01-18
    Journal
    Journal of the American College of Cardiology
    Publisher
    Elsevier Inc.
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.1016/j.jacc.2020.11.031
    Abstract
    To investigate whether severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2)–induced myocarditis constitutes an important mechanism of cardiac injury, a review was conducted of the published data and the authors’ experience was added from autopsy examination of 16 patients dying of SARS-CoV-2 infection. Myocarditis is an uncommon pathologic diagnosis occurring in 4.5% of highly selected cases undergoing autopsy or endomyocardial biopsy. Although polymerase chain reaction–detectable virus could be found in the lungs of most coronavirus disease-2019 (COVID-19)–infected subjects in our own autopsy registry, in only 2 cases was the virus detected in the heart. It should be appreciated that myocardial inflammation alone by macrophages and T cells can be seen in noninfectious deaths and COVID-19 cases, but the extent of each is different, and in neither case do such findings represent clinically relevant myocarditis. Given its extremely low frequency and unclear therapeutic implications, the authors do not advocate use of endomyocardial biopsy to diagnose myocarditis in the setting of COVID-19.
    Rights/Terms
    Copyright © 2021 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
    Keyword
    COVID-19
    SARS-CoV-2
    cardiovascular disease
    heart
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/14671
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jacc.2020.11.031
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    UMB Open Access Articles
    UMB Coronavirus Publications

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