SARS-CoV-2 induced myocarditis: a state-of-the-art review

Nappi, F. and Singh, S. S. A. (2023) SARS-CoV-2 induced myocarditis: a state-of-the-art review. Viruses, 15(4), 916. (doi: 10.3390/v15040916) (PMID:37112896) (PMCID:PMC10145666)

[img] Text
295601.pdf - Published Version
Available under License Creative Commons Attribution.



In this review, we investigated whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can directly cause myocarditis with severe myocardial damage induced by viral particles. A review of the major data published from 2020 to 2022 was performed by consulting the major databases alongside first-hand experiences that emerged from the cardiac biopsies and autopsy examinations of patients who died of SARS-CoV-2 infections. From this study, a significantly large amount of data suggests that the Dallas criteria were met in a residual percentage of patients, demonstrating that SARS-CoV-2 myocarditis was a rare clinical and pathological entity that occurred in a small percentage of subjects. All cases described here were highly selected and subjected to autopsies or endomyocardial biopsies (EMBs). The most important discovery, through the detection of the SARS-CoV-2 genome using the polymerase chain reaction, consisted in the presence of the viral genome in the lung tissue of most of the patients who died from COVID-19. However, the discovery of the SARS-CoV-2 viral genome was a rare event in cardiac tissue from autopsy findings of patients who died of myocarditis It is important to emphasize that myocardial inflammation alone, as promoted by macrophages and T cell infiltrations, can be observed in noninfectious deaths and COVID-19 cases, but the extent of each cause is varied, and in neither case have such findings been reported to support clinically relevant myocarditis. Therefore, in the different infected vs. non-infected samples examined, none of our findings provide a definitive histochemical assessment for the diagnosis of myocarditis in the majority of cases evaluated. We report evidence suggesting an extremely low frequency of viral myocarditis that has also been associated with unclear therapeutic implications. These two key factors strongly point towards the use of an endomyocardial biopsy to irrefutably reach a diagnosis of viral myocarditis in the context of COVID-19.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Singh, Mr Sanjeet
Creator Roles:
Singh, S. S. A.Methodology, Software, Validation, Formal analysis, Data curation, Writing – review and editing, Visualization, Supervision
Authors: Nappi, F., and Singh, S. S. A.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Viruses
ISSN (Online):1999-4915
Published Online:02 April 2023
Copyright Holders:Copyright © 2023 by the authors
First Published:First published in Viruses 15(4):916
Publisher Policy:Reproduced under a Creative Commons license

University Staff: Request a correction | Enlighten Editors: Update this record