The Spectrum of COVID-19-Associated Myocarditis: A Patient-Tailored Multidisciplinary Approach.

COVID-19 SARS-CoV-2 cardiac magnetic resonance endomyocardial biopsy immunosuppression inflammation multidisciplinary myocarditis ventricular arrhythmias

Journal

Journal of clinical medicine
ISSN: 2077-0383
Titre abrégé: J Clin Med
Pays: Switzerland
ID NLM: 101606588

Informations de publication

Date de publication:
04 May 2021
Historique:
received: 17 03 2021
revised: 08 04 2021
accepted: 22 04 2021
entrez: 2 6 2021
pubmed: 3 6 2021
medline: 3 6 2021
Statut: epublish

Résumé

Myocarditis lacks systematic characterization in COVID-19 patients. We enrolled consecutive patients with newly diagnosed myocarditis in the context of COVID-19 infection. Diagnostic and treatment strategies were driven by a dedicated multidisciplinary disease unit for myocarditis. Multimodal outcomes were assessed during prospective follow-up. Seven consecutive patients (57% males, age 51 ± 9 y) with acute COVID-19 infection received a de novo diagnosis of myocarditis. Endomyocardial biopsy was of choice in hemodynamically unstable patients ( Myocarditis associated with acute COVID-19 infection is a spectrum of clinical manifestations and underlying etiologies. A multidisciplinary approach is the cornerstone for tailored management.

Sections du résumé

BACKGROUND BACKGROUND
Myocarditis lacks systematic characterization in COVID-19 patients.
METHODS METHODS
We enrolled consecutive patients with newly diagnosed myocarditis in the context of COVID-19 infection. Diagnostic and treatment strategies were driven by a dedicated multidisciplinary disease unit for myocarditis. Multimodal outcomes were assessed during prospective follow-up.
RESULTS RESULTS
Seven consecutive patients (57% males, age 51 ± 9 y) with acute COVID-19 infection received a de novo diagnosis of myocarditis. Endomyocardial biopsy was of choice in hemodynamically unstable patients (
CONCLUSIONS CONCLUSIONS
Myocarditis associated with acute COVID-19 infection is a spectrum of clinical manifestations and underlying etiologies. A multidisciplinary approach is the cornerstone for tailored management.

Identifiants

pubmed: 34064463
pii: jcm10091974
doi: 10.3390/jcm10091974
pmc: PMC8124580
pii:
doi:

Types de publication

Journal Article

Langues

eng

Références

Circulation. 2020 Jun 9;141(23):1903-1914
pubmed: 32297796
Europace. 2016 Dec;18(12):1850-1859
pubmed: 26589624
Cardiovasc Pathol. 2012 Nov-Dec;21(6):476-81
pubmed: 22425629
Pacing Clin Electrophysiol. 2020 Aug;43(8):891-893
pubmed: 32543745
J Am Coll Cardiol. 2018 Dec 18;72(24):3158-3176
pubmed: 30545455
J Interv Card Electrophysiol. 2020 May 18;:1-7
pubmed: 32425656
Heart Rhythm. 2019 May;16(5):793-801
pubmed: 30476544
JACC Cardiovasc Imaging. 2021 Jan;14(1):288-292
pubmed: 32305473
Circ Heart Fail. 2020 Nov;13(11):e007405
pubmed: 33176455
JACC Clin Electrophysiol. 2020 Oct;6(10):1221-1234
pubmed: 33092747
JACC Cardiovasc Imaging. 2020 Nov;13(11):2462-2465
pubmed: 32654966
Ann Intern Med. 2018 Dec 4;169(11):819-820
pubmed: 30073251
Circ Heart Fail. 2020 Nov 12;:CIRCHEARTFAILURE120007636
pubmed: 33176456
Eur Heart J. 2020 Jun 7;41(22):2124-2125
pubmed: 32363406
Eur Heart J. 2020 May 14;41(19):1861-1862
pubmed: 32267502
Eur Heart J. 2009 Aug;30(16):1995-2002
pubmed: 19556262
Eur Heart J. 2020 Oct 14;41(39):3827-3835
pubmed: 32968776
JAMA. 2020 May 12;323(18):1824-1836
pubmed: 32282022
Am Heart J. 2020 Nov;229:121-126
pubmed: 32957030
Circulation. 2007 Jan 2;115(1):76-83
pubmed: 17179019
Eur J Intern Med. 2020 Jul;77:9-17
pubmed: 32402564
Nat Rev Cardiol. 2021 Mar;18(3):169-193
pubmed: 33046850
J Am Coll Cardiol. 2020 Mar 10;75(9):1046-1057
pubmed: 32138965
Eur Heart J. 2013 Sep;34(33):2636-48, 2648a-2648d
pubmed: 23824828
Clin Chem. 2020 Apr 1;66(4):549-555
pubmed: 32031583

Auteurs

Giovanni Peretto (G)

Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
School of Medicine, San Raffaele Vita-Salute University, 20132 Milan, Italy.

Andrea Villatore (A)

School of Medicine, San Raffaele Vita-Salute University, 20132 Milan, Italy.

Stefania Rizzo (S)

Department of Cardiac Thoracic Vascular Sciences and Public Health, Cardiovascular Pathology, Padua University, 35128 Padua, Italy.

Antonio Esposito (A)

Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
School of Medicine, San Raffaele Vita-Salute University, 20132 Milan, Italy.
Experimental Imaging Center, Radiology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Giacomo De Luca (G)

Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Anna Palmisano (A)

Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Experimental Imaging Center, Radiology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Davide Vignale (D)

Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Experimental Imaging Center, Radiology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Alberto Maria Cappelletti (AM)

Department of Clinical Cardiology and Intensive Care Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Moreno Tresoldi (M)

Unit of General Medicine and Advanced Care, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
COVID-19 Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Corrado Campochiaro (C)

Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Silvia Sartorelli (S)

Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Marco Ripa (M)

COVID-19 Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Department of Infectious Diseases, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Monica De Gaspari (M)

Department of Cardiac Thoracic Vascular Sciences and Public Health, Cardiovascular Pathology, Padua University, 35128 Padua, Italy.

Elena Busnardo (E)

Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Department of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Paola Ferro (P)

Department of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Maria Grazia Calabrò (MG)

Cardiac Surgery Intensive Care Unit, Division of Anesthesiology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Evgeny Fominskiy (E)

Cardiac Surgery Intensive Care Unit, Division of Anesthesiology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Fabrizio Monaco (F)

Cardiac Surgery Intensive Care Unit, Division of Anesthesiology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Giulio Cavalli (G)

Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Luigi Gianolli (L)

Department of Nuclear Medicine, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Francesco De Cobelli (F)

School of Medicine, San Raffaele Vita-Salute University, 20132 Milan, Italy.
Experimental Imaging Center, Radiology Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Alberto Margonato (A)

Department of Clinical Cardiology and Intensive Care Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Lorenzo Dagna (L)

School of Medicine, San Raffaele Vita-Salute University, 20132 Milan, Italy.
Unit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Mara Scandroglio (M)

Cardiac Surgery Intensive Care Unit, Division of Anesthesiology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Paolo Guido Camici (PG)

School of Medicine, San Raffaele Vita-Salute University, 20132 Milan, Italy.

Patrizio Mazzone (P)

Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Paolo Della Bella (P)

Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Cristina Basso (C)

Department of Cardiac Thoracic Vascular Sciences and Public Health, Cardiovascular Pathology, Padua University, 35128 Padua, Italy.

Simone Sala (S)

Department of Cardiac Electrophysiology and Arrhythmology, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.
Myocarditis Disease Unit, IRCCS San Raffaele Scientific Institute, 20132 Milan, Italy.

Classifications MeSH