Case report of cardiogenic shock in COVID-19 myocarditis: peculiarities on diagnosis, histology, and treatment

Author:

Fiore Giorgio1ORCID,Sanvito Francesca2ORCID,Fragasso Gabriele13,Spoladore Roberto4ORCID

Affiliation:

1. Clinical Cardiology Unit, IRCCS San Raffaele University Hospital, Milan, Italy

2. Pathology Unit, Division of Experimental Oncology, IRCCS San Raffaele University Hospital, Milan, Italy

3. Head Heart Failure Unit, IRCCS San Raffaele University Hospital, Milan, Italy

4. Cardiology Department, Manzoni Hospital, ASST Lecco, Italy

Abstract

Abstract Background The year 2020 was dramatically characterized by SARS-CoV-2 pandemic outbreak. COVID-19-related heart diseases and myocarditis have been reported. Case summary A 45-year-old healthy male was admitted to the intensive care unit of our hospital because of cardiogenic shock. A diagnosis of COVID-19 infection and myocarditis was done. We present here several peculiarities about diagnostic workup, myocardial histological findings, choice of treatment, and the patient clinical course at 3 and 8 months of follow-up. Discussion COVID-19 myocardial damage and myocarditis are mainly linked to the cytokine storm with mild myocardial inflammatory infiltrate and very unusual platelet microclots in the setting of the microvascular obstructive thrombo-inflammatory syndrome. Counteracting the inflammatory burden with an interleukine-1 inhibitor appeared safe and led to a dramatic and stable improvement of cardiac function.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine

Reference13 articles.

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2. Evaluating the accuracy of different respiratory specimens in the laboratory diagnosis and monitoring the viral shedding of 2019-nCoV infections;Yang;Innovation (N Y),2020

3. Evidence of SARS-CoV-2 mRNA in endomyocardial biopsies of patients with clinically suspected myocarditis tested negative for COVID-19 in nasopharyngeal swab;Wenzel;Cardiovasc Res,2020

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5. Myocardial injury and COVID-19: possible mechanisms;Babapoor-Farrokhran;Life Sci,2020

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