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Systematic review of case reports on COVID-19 associated myocarditis: a discussion on treatments
Journal article   Open access   Peer reviewed

Systematic review of case reports on COVID-19 associated myocarditis: a discussion on treatments

Vanessa Lim, Gopal Topiwala, Emiliya Apinova and Marina Diioia
Virology journal, v 21(1), 252
09 Oct 2024
DOI: https://doi.org/10.1186/s12985-024-02499-4
PMID: 39385302
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.1186/s12985-024-02499-4View
Published, Version of Record (VoR) Open

Abstract

Biomedical and Life Sciences Biomedicine Coronaviruses: emerging and re-emerging pathogens in humans and animals Review Virology
Although COVID-19 is a disease consisting of mostly upper and lower respiratory symptoms, a subset of patients develop cardiac sequelae including myocarditis and pericarditis. For these patients, a standardized set of diagnostic imaging techniques and treatments has not been established. While there have been numerous case reports on this topic, there are few reviews that evaluate the effectiveness of different treatment modalities with a significant number of cases. We reviewed 146 cases of patients (ages ranging from 2 months old to mid 80 s) obtained from searches on PubMed, Google Scholar, and several case report journals. ECG abnormalities, elevated inflammatory markers, and reduced left ventricular ejection fraction were most associated with COVID-19 myocarditis. While classic symptoms of COVID-19 include upper respiratory symptoms, a subset of patients diagnosed with COVID-19 displayed no signs of respiratory disease at all. In 22% of cases, cardiac sequelae was not present until after the patient recovered from COVID-19. Steroids were given in 57.5% of cases. Cardiac MRI was used in 40.4% of cases for diagnosis of myocarditis. Of all the patients who were treated with ECMO, 82.1% of these patients were able to fully recover. The use of cardiac MRI and transthoracic echocardiogram for diagnosis of COVID-19 myocarditis should be heavily considered in any patient with COVID-19 infection. ECMO, IVIG, steroids, and anticoagulants should also be heavily considered. A randomized controlled trial should be conducted to better associate treatments with outcomes.

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Web of Science research areas
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