COVID-19-Associated cardiac pathology at the postmortem evaluation: a collaborative systematic review.

Aged Autopsy COVID-19 Humans Lung Myocarditis / epidemiology SARS-CoV-2
COVID-19 Cardiac pathology Myocarditis Postmortem SARS-CoV-2 Systematic review

Journal

Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases
ISSN: 1469-0691
Titre abrégé: Clin Microbiol Infect
Pays: England
ID NLM: 9516420

Informations de publication

Date de publication:
Aug 2022
Historique:
received: 06 01 2022
revised: 10 03 2022
accepted: 14 03 2022
pubmed: 28 3 2022
medline: 27 7 2022
entrez: 27 3 2022
Statut: ppublish

Résumé

Many postmortem studies address the cardiovascular effects of COVID-19 and provide valuable information, but are limited by their small sample size. The aim of this systematic review is to better understand the various aspects of the cardiovascular complications of COVID-19 by pooling data from a large number of autopsy studies. We searched the online databases Ovid EBM Reviews, Ovid Embase, Ovid Medline, Scopus, and Web of Science for concepts of autopsy or histopathology combined with COVID-19, published between database inception and February 2021. We also searched for unpublished manuscripts using the medRxiv services operated by Cold Spring Harbor Laboratory. Articles were considered eligible for inclusion if they reported human postmortem cardiovascular findings among individuals with a confirmed SARS coronavirus type 2 (CoV-2) infection. Confirmed COVID-19 patients with post-mortem cardiovascular findings. None. Studies were individually assessed for risk of selection, detection, and reporting biases. The median prevalence of different autopsy findings with associated interquartile ranges (IQRs). This review cohort contained 50 studies including 548 hearts. The median age of the deceased was 69 years. The most prevalent acute cardiovascular findings were myocardial necrosis (median: 100.0%; IQR, 20%-100%; number of studies = 9; number of patients = 64) and myocardial oedema (median: 55.5%; IQR, 19.5%-92.5%; number of studies = 4; number of patients = 46). The median reported prevalence of extensive, focal active, and multifocal myocarditis were all 0.0%. The most prevalent chronic changes were myocyte hypertrophy (median: 69.0%; IQR, 46.8%-92.1%) and fibrosis (median: 35.0%; IQR, 35.0%-90.5%). SARS-CoV-2 was detected in the myocardium with median prevalence of 60.8% (IQR 40.4-95.6%). Our systematic review confirmed the high prevalence of acute and chronic cardiac pathologies in COVID-19 and SARS-CoV-2 cardiac tropism, as well as the low prevalence of myocarditis in COVID-19.

Sections du résumé

BACKGROUND BACKGROUND
Many postmortem studies address the cardiovascular effects of COVID-19 and provide valuable information, but are limited by their small sample size.
OBJECTIVES OBJECTIVE
The aim of this systematic review is to better understand the various aspects of the cardiovascular complications of COVID-19 by pooling data from a large number of autopsy studies.
DATA SOURCES METHODS
We searched the online databases Ovid EBM Reviews, Ovid Embase, Ovid Medline, Scopus, and Web of Science for concepts of autopsy or histopathology combined with COVID-19, published between database inception and February 2021. We also searched for unpublished manuscripts using the medRxiv services operated by Cold Spring Harbor Laboratory.
STUDY ELIGIBILITY CRITERIA METHODS
Articles were considered eligible for inclusion if they reported human postmortem cardiovascular findings among individuals with a confirmed SARS coronavirus type 2 (CoV-2) infection.
PARTICIPANTS METHODS
Confirmed COVID-19 patients with post-mortem cardiovascular findings.
INTERVENTIONS METHODS
None.
METHODS METHODS
Studies were individually assessed for risk of selection, detection, and reporting biases. The median prevalence of different autopsy findings with associated interquartile ranges (IQRs).
RESULTS RESULTS
This review cohort contained 50 studies including 548 hearts. The median age of the deceased was 69 years. The most prevalent acute cardiovascular findings were myocardial necrosis (median: 100.0%; IQR, 20%-100%; number of studies = 9; number of patients = 64) and myocardial oedema (median: 55.5%; IQR, 19.5%-92.5%; number of studies = 4; number of patients = 46). The median reported prevalence of extensive, focal active, and multifocal myocarditis were all 0.0%. The most prevalent chronic changes were myocyte hypertrophy (median: 69.0%; IQR, 46.8%-92.1%) and fibrosis (median: 35.0%; IQR, 35.0%-90.5%). SARS-CoV-2 was detected in the myocardium with median prevalence of 60.8% (IQR 40.4-95.6%).
CONCLUSIONS CONCLUSIONS
Our systematic review confirmed the high prevalence of acute and chronic cardiac pathologies in COVID-19 and SARS-CoV-2 cardiac tropism, as well as the low prevalence of myocarditis in COVID-19.

Identifiants

DOI: 10.1016/j.cmi.2022.03.021 PMID: 35339672 PMC: PMC8941843
pubmed: 35339672
pii: S1198-743X(22)00160-4
doi: 10.1016/j.cmi.2022.03.021
pmc: PMC8941843
pii:
doi:

Types de publication

Journal Article Review Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

1066-1075

Subventions

Organisme : Wellcome Trust
Pays : United Kingdom

Informations de copyright

Copyright © 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Auteurs

Raghed Almamlouk (R)

College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

Tarek Kashour (T)

Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University Medical City, Riyadh, Saudi Arabia.

Sawsan Obeidat (S)

College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

Melanie C Bois (MC)

Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.

Joseph J Maleszewski (JJ)

Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.

Osama A Omrani (OA)

The Royal London Hospital, Barts Health NHS Trust, London, UK; Barts and the London School of Medicine and Dentistry, Queen Mary University, London, UK.

Rana Tleyjeh (R)

College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.

Elie Berbari (E)

Division of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.

Zaher Chakhachiro (Z)

Department of Pathology and Laboratory Medicine, American University of Beirut, Beirut, Lebanon.

Bassel Zein-Sabatto (B)

Department of Pathology and Laboratory Medicine, American University of Beirut, Beirut, Lebanon.

Dana Gerberi (D)

Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA.

Imad M Tleyjeh (IM)

College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Division of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN, USA; Infectious Diseases Section, Department of Medical Specialties King Fahad Medical City, Riyadh, Saudi Arabia; Division of Epidemiology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA. Electronic address: Tleyjeh.Imad@mayo.edu.

Alberto E Paniz Mondolfi (AE)

Department of Pathology, Molecular and Cell-Based Medicine, New York, NY, USA.

Aloke V Finn (AV)

CVPath Institute, Inc., Gaithersburg, and University of Maryland, Baltimore, MD, USA.

Amaro Nunes Duarte-Neto (AN)

Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Amy V Rapkiewicz (AV)

NYU Winthrop Hospital, Department of Pathology, Long Island School of Medicine, Long Island, NY, USA.

Andrea Frustaci (A)

Department of Clinical, Internal, Anesthesiologist and Cardiovascular Sciences, La Sapienza University, Rome, Italy; Cellular and Molecular Cardiology Lab, IRCCS L. Spallanzani, Rome, Italy.

Arthur-Atilla Keresztesi (AA)

Fogolyan Kristof Emergency County Hospital, Covasna County Institution of Forensic Medicine, Covasna, Romania.

Brian Hanley (B)

Department of Cellular Pathology, Northwest London Pathology, Imperial College London NHS Trust, London, UK; Centre for Inflammatory Disease, Imperial College London, London, UK.

Bruno Märkl (B)

Institute of Pathology and Molecular Diagnostics, University Medical Center Augsburg, Augsburg, Germany.

Christelle Lardi (C)

University Center of Legal Medicine, Geneva University Hospital, Geneva, Switzerland.

Clare Bryce (C)

Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Diana Lindner (D)

Department of Cardiology, University Heart and Vascular Centre, Hamburg, Germany; DZHK-German Center for Cardiovascular Research, Partner site, Hamburg/Kiel/Lübeck, Germany.

Diego Aguiar (D)

University Center of Legal Medicine, Geneva University Hospital, Geneva, Switzerland.

Dirk Westermann (D)

Department of Cardiology, University Heart and Vascular Centre, Hamburg, Germany; DZHK-German Center for Cardiovascular Research, Partner site, Hamburg/Kiel/Lübeck, Germany.

Edana Stroberg (E)

Office of the Chief Medical Examiner, Oklahoma City, OK, USA.

Eric J Duval (EJ)

Office of the Chief Medical Examiner, Oklahoma City, OK, USA.

Esther Youd (E)

Forensic Medicine and Science, University of Glasgow, Glasgow, UK.

Gaetano Pietro Bulfamante (GP)

Unità di Anatomia Patologica, Dipartimento di Scienze della Salute, Università degli Studi di Milano, Milan, Italy; Struttura Complessa di Anatomia Patologica e Genetica Medica, ASST Santi Paolo e Carlo, Milan, Italy.

Isabelle Salmon (I)

Department of Pathology, Erasme Hospital, Université Libre de Bruxelles (ULB), Brussels, Belgium; Centre Universitaire inter Régional d'expertise en Anatomie Pathologique Hospitalière, Jumet, Belgium; DIAPath, Center for Microscopy and Molecular Imaging, ULB, Gosselies, Belgium.

Johann Auer (J)

Department of Cardiology and Intensive Care, St. Josef Hospital Braunau, Austria; Department of Cardiology and Intensive Care, Kepler University of Medicine Linz, Austria.

Joseph J Maleszewski (JJ)

Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.

Klaus Hirschbühl (K)

Department of Hematology and Clinical Oncology, University Medical Center Augsburg, Augsburg, Germany.

Lara Absil (L)

Department of Pathology, Erasme Hospital, ULB, Brussels, Belgium.

Lisa M Barton (LM)

Office of the Chief Medical Examiner, Oklahoma City, OK, USA.

Luiz Fernando Ferraz da Silva (LF)

Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil; Serviço de Verificação de Óbitos da Capital, Universidade de São Paulo, São Paulo, Brazil.

Luiza Moore (L)

Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Ageing and Somatic Mutation, Wellcome Sanger Institute, Cambridge, UK.

Marisa Dolhnikoff (M)

Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Martin Lammens (M)

Department of Pathology, Antwerp University Hospital, University of Antwerp, Edegem, Belgium.

Melanie C Bois (MC)

Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.

Michael Osborn (M)

Department of Cellular Pathology, Northwest London Pathology, Imperial College London NHS Trust, London, UK; Death Investigation Committee, Royal College of Pathologists, London, UK; Nightingale NHS Hospital, London, UK.

Myriam Remmelink (M)

Department of Pathology, Erasme Hospital, ULB, Brussels, Belgium.

Paulo Hilario Nascimento Saldiva (PH)

Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Philippe G Jorens (PG)

Infla-Med Research Consortium of Excellence, University of Antwerp, Antwerp, Belgium; Department of Medicine and Health Sciences, Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Antwerp, Belgium; Department of Intensive Care Medicine, Antwerp University Hospital, University of Antwerp, Edegem, Belgium.

Randall Craver (R)

Children's Hospital of New Orleans and Louisiana State University Health Sciences Center, New Orleans, LA, USA.

Renata Aparecida de Almeida Monteiro (R)

Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Roberto Scendoni (R)

Institute of Legal Medicine, Department of Law, University of Macerata, Macerata, Italy.

Sanjay Mukhopadhyay (S)

Department of Pathology, Cleveland Clinic, Cleveland, OH, USA.

Tadaki Suzuki (T)

National Institute of Infectious Diseases, Tokyo, Japan.

Thais Mauad (T)

Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.

Tony Fracasso (T)

University Center of Legal Medicine, Geneva University Hospital, Geneva, Switzerland.

Zachary Grimes (Z)

Icahn School of Medicine at Mount Sinai, New York, NY, USA.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › COVID-19-Associated cardiac pathology at the...
questionsmedicales.fr › Sciences sociales › Criminologie › Sciences légales › Médecine légale › Autopsie › COVID-19-Associated cardiac pathology at the...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › COVID-19-Associated cardiac pathology at the...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › COVID-19-Associated cardiac pathology at the...
questionsmedicales.fr › Appareil respiratoire › Poumon › COVID-19-Associated cardiac pathology at the...
questionsmedicales.fr › Maladies cardiovasculaires › Cardiopathies › Cardiomyopathies › Myocardite › COVID-19-Associated cardiac pathology at the...
questionsmedicales.fr › Virus › Virus à ARN › Virus à ARN à brin positif › Nidovirales › Coronaviridae › Coronavirus › Betacoronavirus › Virus du SRAS › SARS-CoV-2 › COVID-19-Associated cardiac pathology at the...