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COVID-19-Associated cardiac pathology at the postmortem evaluation: a collaborative systematic review.
Almamlouk, Raghed; Kashour, Tarek; Obeidat, Sawsan; Bois, Melanie C; Maleszewski, Joseph J; Omrani, Osama A; Tleyjeh, Rana; Berbari, Elie; Chakhachiro, Zaher; Zein-Sabatto, Bassel; Gerberi, Dana; Tleyjeh, Imad M; Paniz Mondolfi, Alberto E; Finn, Aloke V; Duarte-Neto, Amaro Nunes; Rapkiewicz, Amy V; Frustaci, Andrea; Keresztesi, Arthur-Atilla; Hanley, Brian; Märkl, Bruno; Lardi, Christelle; Bryce, Clare; Lindner, Diana; Aguiar, Diego; Westermann, Dirk; Stroberg, Edana; Duval, Eric J; Youd, Esther; Bulfamante, Gaetano Pietro; Salmon, Isabelle; Auer, Johann; Maleszewski, Joseph J; Hirschbühl, Klaus; Absil, Lara; Barton, Lisa M; Ferraz da Silva, Luiz Fernando; Moore, Luiza; Dolhnikoff, Marisa; Lammens, Martin; Bois, Melanie C; Osborn, Michael; Remmelink, Myriam; Nascimento Saldiva, Paulo Hilario; Jorens, Philippe G; Craver, Randall; Aparecida de Almeida Monteiro, Renata; Scendoni, Roberto; Mukhopadhyay, Sanjay; Suzuki, Tadaki; Mauad, Thais.
  • Almamlouk R; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
  • Kashour T; Department of Cardiac Sciences, King Fahad Cardiac Center, King Saud University Medical City, Riyadh, Saudi Arabia.
  • Obeidat S; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
  • Bois MC; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
  • Maleszewski JJ; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
  • 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.
  • Tleyjeh R; College of Medicine, Alfaisal University, Riyadh, Saudi Arabia.
  • Berbari E; Division of Infectious Diseases, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.
  • Chakhachiro Z; Department of Pathology and Laboratory Medicine, American University of Beirut, Beirut, Lebanon.
  • Zein-Sabatto B; Department of Pathology and Laboratory Medicine, American University of Beirut, Beirut, Lebanon.
  • Gerberi D; Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA.
  • 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, Ma
  • Paniz Mondolfi AE; Department of Pathology, Molecular and Cell-Based Medicine, New York, NY, USA.
  • Finn AV; CVPath Institute, Inc., Gaithersburg, and University of Maryland, Baltimore, MD, USA.
  • Duarte-Neto AN; Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  • Rapkiewicz AV; NYU Winthrop Hospital, Department of Pathology, Long Island School of Medicine, Long Island, NY, USA.
  • 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.
  • Keresztesi AA; Fogolyan Kristof Emergency County Hospital, Covasna County Institution of Forensic Medicine, Covasna, Romania.
  • 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.
  • Märkl B; Institute of Pathology and Molecular Diagnostics, University Medical Center Augsburg, Augsburg, Germany.
  • Lardi C; University Center of Legal Medicine, Geneva University Hospital, Geneva, Switzerland.
  • Bryce C; Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • Lindner D; Department of Cardiology, University Heart and Vascular Centre, Hamburg, Germany; DZHK-German Center for Cardiovascular Research, Partner site, Hamburg/Kiel/Lübeck, Germany.
  • Aguiar D; University Center of Legal Medicine, Geneva University Hospital, Geneva, Switzerland.
  • Westermann D; Department of Cardiology, University Heart and Vascular Centre, Hamburg, Germany; DZHK-German Center for Cardiovascular Research, Partner site, Hamburg/Kiel/Lübeck, Germany.
  • Stroberg E; Office of the Chief Medical Examiner, Oklahoma City, OK, USA.
  • Duval EJ; Office of the Chief Medical Examiner, Oklahoma City, OK, USA.
  • Youd E; Forensic Medicine and Science, University of Glasgow, Glasgow, UK.
  • 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.
  • 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.
  • 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.
  • Maleszewski JJ; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.
  • Hirschbühl K; Department of Hematology and Clinical Oncology, University Medical Center Augsburg, Augsburg, Germany.
  • Absil L; Department of Pathology, Erasme Hospital, ULB, Brussels, Belgium.
  • Barton LM; Office of the Chief Medical Examiner, Oklahoma City, OK, USA.
  • 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.
  • Moore L; Department of Histopathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; Ageing and Somatic Mutation, Wellcome Sanger Institute, Cambridge, UK.
  • Dolhnikoff M; Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  • Lammens M; Department of Pathology, Antwerp University Hospital, University of Antwerp, Edegem, Belgium.
  • Bois MC; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
  • 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.
  • Remmelink M; Department of Pathology, Erasme Hospital, ULB, Brussels, Belgium.
  • Nascimento Saldiva PH; Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  • 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, Universit
  • Craver R; Children's Hospital of New Orleans and Louisiana State University Health Sciences Center, New Orleans, LA, USA.
  • Aparecida de Almeida Monteiro R; Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
  • Scendoni R; Institute of Legal Medicine, Department of Law, University of Macerata, Macerata, Italy.
  • Mukhopadhyay S; Department of Pathology, Cleveland Clinic, Cleveland, OH, USA.
  • Suzuki T; National Institute of Infectious Diseases, Tokyo, Japan.
  • Mauad T; Departamento de Patologia, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Clin Microbiol Infect ; 28(8): 1066-1075, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1859445
ABSTRACT

BACKGROUND:

Many postmortem studies address the cardiovascular effects of COVID-19 and provide valuable information, but are limited by their small sample size.

OBJECTIVES:

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 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 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:

Confirmed COVID-19 patients with post-mortem cardiovascular findings.

INTERVENTIONS:

None.

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:

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:

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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Myocarditis Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Aged / Humans Language: English Journal: Clin Microbiol Infect Journal subject: Communicable Diseases / Microbiology Year: 2022 Document Type: Article Affiliation country: J.cmi.2022.03.021

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Myocarditis Type of study: Cohort study / Experimental Studies / Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Limits: Aged / Humans Language: English Journal: Clin Microbiol Infect Journal subject: Communicable Diseases / Microbiology Year: 2022 Document Type: Article Affiliation country: J.cmi.2022.03.021