Myocarditis is rare in COVID-19 autopsies: cardiovascular findings across 277 postmortem examinations.
Myocarditis is rare in COVID-19 autopsies: cardiovascular findings across 277 postmortem examinations.
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DOI：
10.1016/j.carpath.2020.107300
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发表时间：
2021-01
期刊：
影响因子：
--
通讯作者：
Vander Heide RS
中科院分区：
文献类型：
--
作者：
Halushka MK;Vander Heide RS
由严重急性呼吸系统综合征(SARS)-CoV-2引起的COVID-19大流行是全球死亡的一个主要原因，其中有重要的心血管成分。虽然在死后检查中报告了许多不同的心血管组织病理学，但由于在任何给定的研究中病例数量有限，其发生率尚不清楚。对22份COVID-19阳性患者的独立出版物进行了文献综述，确定了277个尸检心脏。尸检队列的中位年龄为75岁，97.6%有一种或多种合并症。对数据的初步回顾表明，20例心脏存在心肌炎（7.2%）；然而，对其他报告信息的进一步检查显示，大多数病例可能没有功能显著性，心肌炎的真实患病率可能要低得多（<2%）。在47.8%的病例中报告了至少一种急性的、可能与covid -19相关的心血管组织病理学发现，如宏观或微血管血栓、炎症或腔内巨核细胞。不同研究间组织病理学结果的报告存在显著差异，表明观察结果存在较大偏差，报告需要更加一致。总之，在277例病例中，与covid -19相关的心脏组织病理学结果很常见，而心肌炎很少见。
The COVID-19 pandemic, the result of severe acute respiratory syndrome (SARS)-CoV-2, is a major cause of worldwide mortality with a significant cardiovascular component. While a number of different cardiovascular histopathologies have been reported at postmortem examination, their incidence is unknown, due to limited numbers of cases in any given study. A literature review was performed identifying 277 autopsied hearts across 22 separate publications of COVID-19 positive patients. The median age of the autopsy cohort was 75 and 97.6% had one or more comorbidities. Initial review of the data indicate that myocarditis was present in 20 hearts (7.2%); however, closer examination of additional reported information revealed that most cases were likely not functionally significant and the true prevalence of myocarditis is likely much lower (<2%). At least one acute, potentially COVID-19-related cardiovascular histopathologic finding, such as macro or microvascular thrombi, inflammation, or intraluminal megakaryocytes, was reported in 47.8% of cases. Significant differences in reporting of histopathologic findings occurred between studies indicating strong biases in observations and the need for more consistency in reporting. In conclusion, across 277 cases, COVID-19-related cardiac histopathological findings, are common, while myocarditis is rare.
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