Myocarditis associated with Covid-19 disease: a systematic review of
published Case reports and Case series
Abstract
Background: Covid-19 is an extremely contagious illness caused by the
severe acute respiratory syndrome (SARS-CoV-2) virus. Although this
disease primarily involves pulmonary tissue, rapidly advancing research
has established cardiac involvement in Covid-19 patients. Objective:
This systematic review article aimed to compile and illustrate clinical
characteristics, diagnostic findings, management, and outcomes
manifesting in myocarditis linked with Covid-19. Methods: A literature
search was accomplished for published eligible articles with
MEDLINE/PubMed and Embase databases. All eligible case reports and case
series were included from around the world without any language
restrictions. For this review, inclusion criteria were
laboratory-confirmed SARS-CoV-2 infection cases reporting a diagnosis of
acute myocarditis. Results: Data from 41 studies describing myocarditis
in 42 Covid-19 patients was obtained. The median age of these patients
was 43.4 years, with 71.4% of them being male. Fever was the most
prevalent presenting symptoms seen in 57% of patients. Hypertension was
the most pervasive comorbidity accompanying these patients. Cardiac
biomarkers troponin and Brain natriuretic peptide (BNP) were raised in
almost 90% and 87% of patients, respectively. Electrocardiogram
findings were Non-specific and included ST-segment and T-wave changes.
The most prevalent histopathological feature appreciated was diffuse
lymphocytic inflammatory infiltrates. Antivirals and corticosteroids
were the most frequently used medications. About 38% of patients also
needed vasopressor assistance. Out of 42 patients, 67% recovered, and
eight died. Conclusion: Due to the risk of a sudden worsening of
patients conditions and myocarditis association with considerable
mortality and morbidity, a knowledge of this cardiac complication of
Covid-19 disease is crucial for healthcare professionals.