Coronavirus-induced myocarditis: A meta-summary of cases
Coronavirus-induced myocarditis: A meta-summary of cases
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DOI：
10.1016/j.hrtlng.2020.08.013
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发表时间：
2020-11-01
期刊：
影响因子：
2.8
通讯作者：
Wong, Raymond C. C.
中科院分区：
文献类型：
--
作者：
Ho, Jamie S. Y.;Sia, Ching-Hui;Wong, Raymond C. C.
背景：SARS-CoV-2感染引起的心肌炎被认为是COVID-19患者心脏损伤的一部分。然而，冠状病毒引起的心肌炎的报告很少。本综述的目的是总结已发表的心肌炎病例，并描述其表现、诊断过程、临床特征和结局。方法：于2020年6月3日对MEDLINE、EMBASE、Scopus、Web of Science、CENTRAL和OpenGrey进行了文献检索。纳入了COVID-19患者心肌炎的研究，排除了仅报告心脏损伤或心力衰竭的研究。如果经心脏磁共振成像（CMR）或组织病理学诊断，则病例为“确诊”心肌炎。那些没有被归类为“可能”心肌炎。结果：共纳入31篇研究，51例患者，12例确诊心肌炎，39例疑似心肌炎。中位年龄为55岁，69%为男性。最常见的症状是发热、呼吸急促、咳嗽和胸痛。心电图改变包括非特异性ST段和T波改变和室性心动过速。大多数患者的心脏和炎症生物标志物升高。左室功能不全和室壁运动功能减退是常见的。CMR诊断10例患者，具有心脏水肿和心脏损伤的特征。5例患者进行了组织病理学检查。一些病例需要机械通气和体外膜肺氧合，30%的患者康复，但27%死亡。结论：COVID-19心肌炎与心电图、心脏生物标志物和超声心动图变化相关，表现严重可能导致死亡。大多数病例无法进行肌内膜活检，但CMR有价值。(c)2020爱思唯尔公司All rights reserved.
Background: Myocarditis caused by SARS-CoV-2 infection was proposed to account for a proportion of cardiac injury in patients with COVID-19. However, reports of coronavirus-induced myocarditis were scarce. The aim of this review was to summarise the published cases of myocarditis and describe their presentations, diag-nostic processes, clinical characteristics and outcomes. Methods: A literature search of MEDLINE, EMBASE, Scopus, Web of Science, CENTRAL and OpenGrey on was performed on 3 June 2020. Studies of myocarditis in patients with COVID-19 were included, and those only reporting cardiac injury or heart failure were excluded. Cases were "confirmed" myocarditis if diagnosed on cardiac magnetic resonance imaging (CMR) or histopathology. Those without were grouped as "possible" myocarditis. Results: A total of 31 studies on 51 patients were included; 12 cases were confirmed myocarditis while 39 had possible myocarditis. The median age was 55 and 69% were male. The most common presenting symptoms were fever, shortness of breath, cough and chest pain. Electrocardiogram changes included non-specific ST segment and T-wave changes and ventricular tachycardia. Most patients had elevated cardiac and inflammatory biomarkers. Left ventricular dysfunction and hypokinesis was common. CMR established the diagnosis in 10 patients, with features of cardiac oedema and cardiac injury. Five patients had histopathological examination. Some cases required mechanical ventilation and extracoporeal membrane oxygenation, and 30% of patients recovered but 27% died. Conclusions: COVID-19 myocarditis was associated with ECG, cardiac biomarker and echocardiographic changes, and the manifestation could be severe leading to mortality. Endomyocardial biopsy was not available in most cases but CMR was valuable. (c) 2020 Elsevier Inc. All rights reserved.