Detection of viral SARS-CoV-2 genomes and histopathological changes in endomyocardial biopsies.
ESC Heart Fail
; 7(5): 2440-2447, 2020 10.
Article
in English
| MEDLINE | ID: covidwho-596164
ABSTRACT
AIMS:
Since December 2019, the novel coronavirus SARS-CoV-2 has spread rapidly throughout China and keeps the world in suspense. Cardiovascular complications with myocarditis and embolism due to COVID-19 have been reported. SARS-CoV-2 genome detection in the heart muscle has not been demonstrated so far, and the underlying pathophysiological mechanisms remain to be investigated. METHODS ANDRESULTS:
Endomyocardial biopsies (EMBs) of 104 patients (mean age 57.90 ± 16.37 years; left ventricular ejection fraction 33.7 ± 14.6%, sex n = 79 male/25 female) with suspected myocarditis or unexplained heart failure were analysed. EMB analysis included histology, immunohistochemistry, and detection of SARS-CoV-2 genomes by real-time reverse transcription polymerase chain reaction in the IKDT Berlin, Germany. Among 104 EMBs investigated, five were confirmed with SARS-CoV-2 infected by reverse real-time transcriptase polymerase chain reaction. We describe patients of different history of symptoms and time duration. Additionally, we investigated histopathological changes in myocardial tissue showing that the inflammatory process in EMBs seemed to permeate vascular wall leading to small arterial obliteration and damage.CONCLUSIONS:
This is the first report that established the evidence of SARS-CoV-2 genomes detection in EMBs. In these patients, myocardial injury ischaemia may play a role, which could explain the ubiquitous troponin increases. EMB-based identification of the cause of myocardial injury may contribute to explain the different evolution of complicated SARS-CoV-2-infection and to design future specific and personalized treatment strategies.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Gene Expression Regulation
/
Coronavirus Infections
/
Severe acute respiratory syndrome-related coronavirus
/
Heart Failure
/
Myocarditis
Type of study:
Cohort study
/
Observational study
/
Prognostic study
Limits:
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Europa
Language:
English
Journal:
ESC Heart Fail
Year:
2020
Document Type:
Article
Affiliation country:
Ehf2.12805
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