Case report of cardiogenic shock in COVID-19 myocarditis: peculiarities on diagnosis, histology, and treatment. Issue 10 (9th September 2021)

• Record Type: Journal Article
• Authors: Fiore, Giorgio; Sanvito, Francesca; Fragasso, Gabriele; Spoladore, Roberto
• Editors: Vágó, Hajnalka; Galyavich, Albert; Yen Yen Moey, Melissa; Parollo, Matteo; Chakir, Mariame
• Is Part Of: European heart journal. Volume 5:Issue 10(2021)
• Publication Date: 2021-09-09
• Subjects: Case report -- Cardiogenic shock -- SARS-CoV-2 -- COVID-19 myocarditis -- Anakinra; Cardiology -- Periodicals; Cardiology -- Case studies -- Periodicals; Heart -- Diseases -- Periodicals; Heart -- Diseases -- Case studies -- Periodicals; 616.12
• DOI: 10.1093/ehjcr/ytab357
• Languages: English
• ISSNs: 2514-2119

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.