Models for COVID-19 Early Cardiac Pathology Following SARS-CoV-2 Infection

Objectives: The clinical manifestations of COVID-19 associated cardiac complications are heterogeneous, ranging from asymptomatic to severe symptoms, including arrhythmias and cardiogenic shock. For COVID-19 patients with cardiac sequela, only a small subset of patients have myocarditis; the pathoge...

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Autores principales:	Maurice Fremont-Smith, Nicole Gherlone, Nora Smith, Philip Tisdall, Darrell O. Ricke
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Myocarditis SARS-CoV-2 COVID-19 mast cell disease cardiac pathology Infectious and parasitic diseases RC109-216
Acceso en línea:	https://doaj.org/article/034152e77fb645f7bd8dde937488b550
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spelling	oai:doaj.org-article:034152e77fb645f7bd8dde937488b5502021-11-16T04:09:11ZModels for COVID-19 Early Cardiac Pathology Following SARS-CoV-2 Infection1201-971210.1016/j.ijid.2021.09.052https://doaj.org/article/034152e77fb645f7bd8dde937488b5502021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1201971221007633https://doaj.org/toc/1201-9712Objectives: The clinical manifestations of COVID-19 associated cardiac complications are heterogeneous, ranging from asymptomatic to severe symptoms, including arrhythmias and cardiogenic shock. For COVID-19 patients with cardiac sequela, only a small subset of patients have myocarditis; the pathogenesis of cardiac sequela caused by SARS-CoV-2 other than microthrombi associated sequela remains to be determined. Methods: Retrospective analysis of 71 heart autopsy specimens from COVID-19 and putative COVID-19 in the NIH COVID Digital Pathology Repository. Results: The most consistent observation was localized myocardial cell death not associated with either myocarditis or microthrombi. Red blood cells were typically absent from capillaries but, when observed, were predominately in linear clusters (stacks) of adjacent cells. Conclusions: Based on our retrospective analysis, we propose that localized ischemia and subsequent cell death by anoxia contributes to the cardiac pathogenesis in some COVID-19 patients. We propose two new models predicting vasoconstriction of cardiac pericyte cells induced by elevated histamine from hyper-activated mast cells or direct infection. We propose that impeded blood flow and cell death by anoxia are initial steps in the development of SARS-CoV-2 induced cardiac injury in COVID-19 patients independent of microthrombi or myocarditis.Maurice Fremont-SmithNicole GherloneNora SmithPhilip TisdallDarrell O. RickeElsevierarticleMyocarditisSARS-CoV-2COVID-19mast cell diseasecardiac pathologyInfectious and parasitic diseasesRC109-216ENInternational Journal of Infectious Diseases, Vol 113, Iss , Pp 331-335 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Myocarditis SARS-CoV-2 COVID-19 mast cell disease cardiac pathology Infectious and parasitic diseases RC109-216
spellingShingle	Myocarditis SARS-CoV-2 COVID-19 mast cell disease cardiac pathology Infectious and parasitic diseases RC109-216 Maurice Fremont-Smith Nicole Gherlone Nora Smith Philip Tisdall Darrell O. Ricke Models for COVID-19 Early Cardiac Pathology Following SARS-CoV-2 Infection
description	Objectives: The clinical manifestations of COVID-19 associated cardiac complications are heterogeneous, ranging from asymptomatic to severe symptoms, including arrhythmias and cardiogenic shock. For COVID-19 patients with cardiac sequela, only a small subset of patients have myocarditis; the pathogenesis of cardiac sequela caused by SARS-CoV-2 other than microthrombi associated sequela remains to be determined. Methods: Retrospective analysis of 71 heart autopsy specimens from COVID-19 and putative COVID-19 in the NIH COVID Digital Pathology Repository. Results: The most consistent observation was localized myocardial cell death not associated with either myocarditis or microthrombi. Red blood cells were typically absent from capillaries but, when observed, were predominately in linear clusters (stacks) of adjacent cells. Conclusions: Based on our retrospective analysis, we propose that localized ischemia and subsequent cell death by anoxia contributes to the cardiac pathogenesis in some COVID-19 patients. We propose two new models predicting vasoconstriction of cardiac pericyte cells induced by elevated histamine from hyper-activated mast cells or direct infection. We propose that impeded blood flow and cell death by anoxia are initial steps in the development of SARS-CoV-2 induced cardiac injury in COVID-19 patients independent of microthrombi or myocarditis.
format	article
author	Maurice Fremont-Smith Nicole Gherlone Nora Smith Philip Tisdall Darrell O. Ricke
author_facet	Maurice Fremont-Smith Nicole Gherlone Nora Smith Philip Tisdall Darrell O. Ricke
author_sort	Maurice Fremont-Smith
title	Models for COVID-19 Early Cardiac Pathology Following SARS-CoV-2 Infection
title_short	Models for COVID-19 Early Cardiac Pathology Following SARS-CoV-2 Infection
title_full	Models for COVID-19 Early Cardiac Pathology Following SARS-CoV-2 Infection
title_fullStr	Models for COVID-19 Early Cardiac Pathology Following SARS-CoV-2 Infection
title_full_unstemmed	Models for COVID-19 Early Cardiac Pathology Following SARS-CoV-2 Infection
title_sort	models for covid-19 early cardiac pathology following sars-cov-2 infection
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/034152e77fb645f7bd8dde937488b550
work_keys_str_mv	AT mauricefremontsmith modelsforcovid19earlycardiacpathologyfollowingsarscov2infection AT nicolegherlone modelsforcovid19earlycardiacpathologyfollowingsarscov2infection AT norasmith modelsforcovid19earlycardiacpathologyfollowingsarscov2infection AT philiptisdall modelsforcovid19earlycardiacpathologyfollowingsarscov2infection AT darrelloricke modelsforcovid19earlycardiacpathologyfollowingsarscov2infection
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Models for COVID-19 Early Cardiac Pathology Following SARS-CoV-2 Infection

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