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10.1038/s41379-021-00790-1

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33727695!9813560!33727695
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suck abstract from ncbi


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pmid33727695      Mod+Pathol 2021 ; 34 (7): 1345-1357
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  • Factors associated with myocardial SARS-CoV-2 infection, myocarditis, and cardiac inflammation in patients with COVID-19 #MMPMID33727695
  • Bearse M; Hung YP; Krauson AJ; Bonanno L; Boyraz B; Harris CK; Helland TL; Hilburn CF; Hutchison B; Jobbagy S; Marshall MS; Shepherd DJ; Villalba JA; Delfino I; Mendez-Pena J; Chebib I; Newton-Cheh C; Stone JR
  • Mod Pathol 2021[Jul]; 34 (7): 1345-1357 PMID33727695show ga
  • COVID-19 has been associated with cardiac injury and dysfunction. While both myocardial inflammatory cell infiltration and myocarditis with myocyte injury have been reported in patients with fatal COVID-19, clinical-pathologic correlations remain limited. The objective was to determine the relationships between cardiac pathological changes in patients dying from COVID-19 and cardiac infection by SARS-CoV-2, laboratory measurements, clinical features, and treatments. In a retrospective study, 41 consecutive autopsies of patients with fatal COVID-19 were analyzed for the associations between cardiac inflammation, myocarditis, cardiac infection by SARS-CoV-2, clinical features, laboratory measurements, and treatments. Cardiac infection was assessed by in situ hybridization and NanoString transcriptomic profiling. Cardiac infection by SARS-CoV-2 was present in 30/41 cases: virus(+) with myocarditis (n = 4), virus(+) without myocarditis (n = 26), and virus(-) without myocarditis (n = 11). In the cases with cardiac infection, SARS-CoV-2(+) cells in the myocardium were rare, with a median density of 1 cell/cm(2). Virus(+) cases showed higher densities of myocardial CD68(+) macrophages and CD3(+) lymphocytes, as well as more electrocardiographic changes (23/27 vs 4/10; P = 0.01). Myocarditis was more prevalent with IL-6 blockade than with nonbiologic immunosuppression, primarily glucocorticoids (2/3 vs 0/14; P = 0.02). Overall, SARS-CoV-2 cardiac infection was less prevalent in patients treated with nonbiologic immunosuppression (7/14 vs 21/24; P = 0.02). Myocardial macrophage and lymphocyte densities overall were positively correlated with the duration of symptoms but not with underlying comorbidities. In summary, cardiac infection with SARS-CoV-2 is common among patients dying from COVID-19 but often with only rare infected cells. Cardiac infection by SARS-CoV-2 is associated with more cardiac inflammation and electrocardiographic changes. Nonbiologic immunosuppression is associated with lower incidences of myocarditis and cardiac infection by SARS-CoV-2.
  • |Aged[MESH]
  • |Anticoagulants/therapeutic use[MESH]
  • |Autopsy[MESH]
  • |COVID-19 Drug Treatment[MESH]
  • |COVID-19/blood/*pathology[MESH]
  • |Echocardiography[MESH]
  • |Electrocardiography[MESH]
  • |Female[MESH]
  • |Humans[MESH]
  • |Immunosuppressive Agents/therapeutic use[MESH]
  • |Male[MESH]
  • |Myocarditis/pathology/virology[MESH]
  • |Myocardium/pathology[MESH]
  • |Retrospective Studies[MESH]


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