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Review
. 2022 Mar;14(1):53-62.
doi: 10.1016/j.ccep.2021.11.001. Epub 2021 Nov 9.

Prevalence and Clinical Implications of COVID-19 Myocarditis

Cristina Chimenti  1 , Michele Magnocavallo  2 , Federico Ballatore  2 , Federico Bernardini  2 , Maria Alfarano  2 , Domenico G Della Rocca  3 , Paolo Severino  2 , Carlo Lavalle  2 , Fedele Francesco  2 , Andrea Frustaci  4
Affiliations
Review

Prevalence and Clinical Implications of COVID-19 Myocarditis

Cristina Chimenti et al. Card Electrophysiol Clin. 2022 Mar.

Abstract

The clinical manifestations of COVID-19 are widely variable and may involve several districts. Although the clinical course is mostly characterized by respiratory involvement, up to 30% of hospitalized patients have evidence of myocardial injury due to acute coronary syndrome, cardiac arrhythmias, myocarditis, and cardiogenic shock. In particular, myocarditis is a well-recognized severe complication of COVID-19 and is associated with fulminant cardiogenic shock and sudden cardiac death. In this article, the authors aim to present a comprehensive review about COVID-19-related myocarditis, including clinical characteristics, diagnostic workup, and management.

Keywords: Arrhythmias; COVID-19; Myocardial damage; Myocarditis; SARS-CoV-2; Vascular damage.

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Conflict of interest statement

Disclosure All authors have reported that they have no relationships relevant to the contents of this article to disclose.

Figures

Fig. 1
Fig. 1
Physiopathogenesis and clinical presentation of COVID-19 myocarditis.
Fig. 2
Fig. 2
Possible mechanism of arrhythmogenesis in COVID-19 myocarditis.
Fig. 3
Fig. 3
Proposed flow-chart for the diagnosis of COVID-19 myocarditis. CAD, coronary artery disease; CMR, cardiac magnetic resonance; COVID-19, coronavirus disease 2019; CTA, computed tomography angiography; EMB, endomyocardial biopsy; PCI, percutaneous coronary intervention.
Fig. 4
Fig. 4
Left ventricular endomyocardial biopsy of a patient with COVID-19 myocarditis. (A) Focal active myocarditis depicted by lymphomononuclear infiltrated (arrows) with necrosis of the adjacent cardiomyocytes (hematoxylin and eosin 10X magnification). (B) Myocarditis was associated with vasculitis of intramural vessels (hematoxylin and eosin 20X magnification).
See this image and copyright information in PMC

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