A Systematic Review of COVID-19 and Myocarditis

Pramod Theetha Kariyanna¹, Bayu Sutarjono², Ekjot Grewal³, Kamal Preet Singh¹, Lyudmila Aurora¹, Leanna Smith¹, Harshith Priyan Chandrakumar⁴, Apoorva Jayarangaiah¹, Sarah A. Goldman¹, Moro O. Salifu¹ and Isabel M. McFarlane^1,

¹Department of Internal Medicine, State University of New York, Downstate Health Sciences University, Brooklyn, NY 11203, USA

²Saba University School of Medicine, 27 Jackson Road, Devens, MA 01434, USA

³Department of Emergency Medicine, Brookdale University Hospital and Medical Center, 1 Brookdale Plaza, Brooklyn, NY 11212, USA

⁴Division of Hematology and Oncology, Department of Internal Medicine, Albert Einstein College of medicine/NYC + HHC Jacobi Medical Center, 1400 Pelham Pkwy S, Bronx, NY, U.S.A- 1046

Cite this paper

Pramod Theetha Kariyanna, Bayu Sutarjono, Ekjot Grewal, Kamal Preet Singh, Lyudmila Aurora, Leanna Smith, Harshith Priyan Chandrakumar, Apoorva Jayarangaiah, Sarah A. Goldman, Moro O. Salifu and Isabel M. McFarlane. A Systematic Review of COVID-19 and Myocarditis. American Journal of Medical Case Reports. 2020; 8(9):299-305. doi: 10.12691/AJMCR-8-9-11

Abstract

Background. The COVID-19 infection which emerged in December 2019, is caused by the virus SARS-CoV-2. Infection with this virus can lead to severe respiratory illness, however, myocarditis has also been reported. The purpose of this study is to identify the clinical features of myocarditis in COVID-19 patients. Methods. A systematic review was conducted to investigate characteristics of myocarditis in patients infected with COVID-19 using the search term “Coronavirus” or “COVID” and “myocarditis,” “heart,” or “retrospective.” Case reports and retrospective studies were gathered by searching Medline/Pubmed, Google Scholar, CINAHL, Cochrane CENTRAL, and Web of Science databases. 11 articles were selected for review. Results. COVID-19 myocarditis affected patients over the age of 50 and incidences among both genders were equally reported. Patients presented with dyspnea, cough, fever with hypotension and chest pain. Laboratory tests revealed leukocytosis with increased C-reactive protein, while arterial blood gas analysis demonstrated respiratory acidosis. All cardiac markers were elevated. Radiographic imaging of the chest showed bilateral ground glass opacities or bilateral infiltrates, while cardiac magnetic resonance imaging produced late gadolinium enhancements. Electrocardiography demonstrated ST-segment elevation or inverted T waves, while echocardiography revealed reduced left ventricular ejection fraction with cardiomegaly or increased wall thickness. Management with corticosteroids was favored in most cases, followed by antiviral medication. The majority of studies reported either recovery or no further clinical deterioration. Conclusion. Current available data on COVID-19 myocarditis is limited. Further research is needed to advance our understanding of COVID-19 myocarditis.

Keywords

COVID-19, SARS-CoV-2, Myocarditis, echocardiogram, cardiac MRI, electrocardiography

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

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