COVID-19-associated myocarditis

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For COVID-19 frequently asked inpatient questions, click here
For COVID-19 frequently asked outpatient questions, click here
For COVID-19 patient information, click here

WikiDoc Resources for COVID-19-associated myocarditis

Articles

Most recent articles on COVID-19-associated myocarditis

Most cited articles on COVID-19-associated myocarditis

Review articles on COVID-19-associated myocarditis

Articles on COVID-19-associated myocarditis in N Eng J Med, Lancet, BMJ

Media

Powerpoint slides on COVID-19-associated myocarditis

Images of COVID-19-associated myocarditis

Photos of COVID-19-associated myocarditis

Podcasts & MP3s on COVID-19-associated myocarditis

Videos on COVID-19-associated myocarditis

Evidence Based Medicine

Cochrane Collaboration on COVID-19-associated myocarditis

Bandolier on COVID-19-associated myocarditis

TRIP on COVID-19-associated myocarditis

Clinical Trials

Ongoing Trials on COVID-19-associated myocarditis at Clinical Trials.gov

Trial results on COVID-19-associated myocarditis

Clinical Trials on COVID-19-associated myocarditis at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on COVID-19-associated myocarditis

NICE Guidance on COVID-19-associated myocarditis

NHS PRODIGY Guidance

FDA on COVID-19-associated myocarditis

CDC on COVID-19-associated myocarditis

Books

Books on COVID-19-associated myocarditis

News

COVID-19-associated myocarditis in the news

Be alerted to news on COVID-19-associated myocarditis

News trends on COVID-19-associated myocarditis

Commentary

Blogs on COVID-19-associated myocarditis

Definitions

Definitions of COVID-19-associated myocarditis

Patient Resources / Community

Patient resources on COVID-19-associated myocarditis

Discussion groups on COVID-19-associated myocarditis

Patient Handouts on COVID-19-associated myocarditis

Directions to Hospitals Treating COVID-19-associated myocarditis

Risk calculators and risk factors for COVID-19-associated myocarditis

Healthcare Provider Resources

Symptoms of COVID-19-associated myocarditis

Causes & Risk Factors for COVID-19-associated myocarditis

Diagnostic studies for COVID-19-associated myocarditis

Treatment of COVID-19-associated myocarditis

Continuing Medical Education (CME)

CME Programs on COVID-19-associated myocarditis

International

COVID-19-associated myocarditis en Espanol

COVID-19-associated myocarditis en Francais

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COVID-19-associated myocarditis in the Marketplace

Patents on COVID-19-associated myocarditis

Experimental / Informatics

List of terms related to COVID-19-associated myocarditis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Mounika Reddy Vadiyala, M.B.B.S.[3]

Synonyms and Keywords: Novel coronavirus, COVID-19, Wuhan coronavirus, coronavirus disease-19, coronavirus disease 2019, SARS-CoV-2, COVID-19, COVID-19, 2019-nCoV, 2019 novel coronavirus, cardiovascular finding in COVID-19, myocardial injury in COVID-19, myocarditis, myocarditis in COVID-19, COVID-19-associated myocarditis, SARS-CoV2-associated myocarditis, myocardial injury in COVID-19, COVID-19 myocarditis

Overview

COVID-19 caused by the novel coronavirus, also known as SARS-CoV-2 mainly affects the lungs may lead to severe acute respiratory syndrome (SARS). It invades through the angiotensin-converting enzyme 2 (ACE2) receptors present abundantly not only in the lungs but also in the heart, kidneys, intestine, brain, skin thus causing multiorgan dysfunction including cardiovascular complications and death. Myocarditis is one of the cardiovascular manifestation of COVID-19 with the risk of arrhythmia as well as progression to fulminant heart failure and cardiogenic shock. The proposed mechanisms including direct invasion through ACE2 receptors and inflammatory response or cytokine storm. In literature, myocardial edema and/or scarring were detected on cardiac MRI of reported myocarditis associated COVID-19.

Historical Perspective

Classification

Pathophysiology

Proposed pathophysiologies of COVID-19 associated myocarditis


Pathological changes in the myocardium

Light microscopy immunostaining of the inflammatory infiltrate. (A,B) Low‐ and high‐power views of endomyocardial biopsy, with sparse CD45RO positive interstitial cells. (C,D) Large, vacuolated macrophages immunostained with anti‐CD68 antibodies. (E) Ultrastructural morphology of a large and cytopathic macrophage. (A–D: the bar scale is in the left low corner of each panel. E: the bar scale is in the right low corner of the panel and corresponds to 2 μm). Case courtesy by Guido Tavazzi[21]


Causes

Myocarditis in COVID-19 is caused by:

Differentiating COVID-19 associated myocarditis from other Diseases

For further information about the differential diagnosis, click here.
For further information about the differential diagnosis of COVID-19, click here.

Epidemiology and Demographics

Age

Gender

Race

Risk Factors

Screening

Natural History, Complications and Prognosis

Natural history

Complications

Common complications of myocarditis include:

Prognosis

Diagnosis

Diagnostic Criteria

  • The diagnosis of myocarditis cannot be made with a single test or examination. When indicated, the diagnosis requires a combination of:

Signs and Symptoms

Clinical presentations have varied in the reported COVID-19 cases with myocarditis in the literature with potential overlap in symptomatology in patients with primary COVID-19 infection and COVID-19 patients with clinically suspected myocarditis. Clinical presentation of COVID-19 related myocarditis varies among cases from mild to severe to fulminant.

Physical Examination

Laboratory Findings

Inflammatory biomarkers

Cardiac biomarkers

Electrocardiogram

Echocardiography

Cardiac Magnetic Resonance

[56]

Cardiac Computed Tomography

Cardiac Computed Tomography cab be useful for diagnosis of myocarditis in covid-19.

Endomyocardial biopsy

Treatment

Medical Therapy

Surgery

  • Surgical intervention is not recommended for the management of COVID-19-associated myocarditis.

Primary Prevention

Secondary Prevention

References

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