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Case Reports
. 2020 Aug;36(8):1326.e5-1326.e7.
doi: 10.1016/j.cjca.2020.06.005. Epub 2020 Jun 6.

First Documentation of Persistent SARS-Cov-2 Infection Presenting With Late Acute Severe Myocarditis

Anna Giulia Pavon  1 , David Meier  2 , Daryoush Samim  3 , David C Rotzinger  4 , Stephane Fournier  2 , Patrick Marquis  5 , Pierre Monney  6 , Olivier Muller  2 , Juerg Schwitter  7
Affiliations
Case Reports

First Documentation of Persistent SARS-Cov-2 Infection Presenting With Late Acute Severe Myocarditis

Anna Giulia Pavon et al. Can J Cardiol. 2020 Aug.

Abstract
in English, French

A 64-year-old man presented with severe myocarditis 6 weeks after an initial almost asymptomatic severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) infection. He was found to have a persistent positive swab. Mechanisms explaining myocardial injury in patients with COVID-19 remains unclear, but this case suggests that severe acute myocarditis can develop in the late phase of COVID-19 infection, even after a symptom-free interval.

Un homme de 64 ans a présenté une myocardite grave six semaines après avoir été infecté par le coronavirus du syndrome respiratoire aigu sévère 2 (SRAS-CoV-2), qui n’avait provoqué pratiquement aucun symptôme. Le patient obtenait toujours un résultat positif au test de dépistage du SRAS-CoV-2. On ne connaît pas bien les mécanismes à l’origine des lésions myocardiques observées chez des patients atteints de COVID-19, mais ce cas montre qu’il est possible qu’une myocardite aiguë grave survienne aux stades avancés d’une infection par le SRAS-CoV-2, même après une période sans symptômes.

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Figures

Figure 1
Figure 1
CMR examination showing 3D reconstructions of inflammatory lesion distribution (red areas, central panel). On the left, extensive inflammatory lesions (red areas) are demonstrated at the subepicardial layer (top), fading toward the subendocardial layer (bottom), which is the typical pattern for myocarditis. To the right of the central panel, the raw images of late gadolinium enhancement (arrows) are shown again, illustrating the subepicardial distribution. On the right, T2 mapping shows increased values in several segments, indicating the presence of edema (numbers are T2 values in ms).
See this image and copyright information in PMC

Comment in

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