SARS-CoV-2 Myocarditis: Insights Into Incidence, Prognosis, and Therapeutic Implications.

Content Provider	Europe PMC
Author	Abou Hassan, Ossama K. Sheng, Calvin C. Wang, Tom Kai Ming Cremer, Paul C.
Abstract	Purpose of ReviewIn coronavirus disease 2019 (COVID-19), myocardial injury occurs frequently in severe or critically ill hospitalized patients, yet myocarditis is much less common. In this context, revisiting the definition of myocarditis is appropriate with a specific focus on diagnostic and management considerations in patients infected with SARS-CoV-2.Recent FindingsPathologic cardiac specimens from patients with COVID-19 suggest a mixed inflammatory response involving lymphocytes and macrophages, and importantly, cellular injury occurs predominantly at the level of pericytes and endothelial cells, less often involving direct myocyte necrosis. In COVID-19, the diagnosis of myocarditis has understandably been based predominantly on clinical criteria, and the number of patients with clinically suspected myocarditis who would meet diagnostic histological criteria is unclear. Echocardiography and cardiac magnetic resonance are important diagnostic tools, although the prognostic implications of abnormalities are still being defined. Importantly, SARS-CoV2 myocarditis should be diagnosed within an appropriate clinical context and should not be based on isolated imaging findings. Therapies in COVID-19 have focused on the major clinical manifestation of pneumonia, but the promotion of viral clearance early in the disease could prevent the development of myocarditis, and further study of immunosuppressive therapies once myocarditis has developed are indicated.SummaryA strict and uniform approach is needed to diagnose myocarditis due to SARS-CoV-2 to better understand the natural history of this disease and to facilitate evaluation of potential therapeutic interventions. A methodological approach will also better inform the incidence of COVID-19 associated myocarditis and potential long-term health effects.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8330199&blobtype=pdf
ISSN	15233782
Journal	Current Cardiology Reports [Curr Cardiol Rep]
Volume Number	23
DOI	10.1007/s11886-021-01551-x
PubMed Central reference number	PMC8330199
Issue Number	9
PubMed reference number	34342728
e-ISSN	15343170
Language	English
Publisher	Springer US
Publisher Date	2021-08-03
Publisher Place	New York
Access Restriction	Open
Rights License	This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2021
Subject Keyword	SARS-CoV-2 COVID-19 Myocardial injury Myocarditis COVID-19 therapy
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine