COVID-19 Infection and Myocarditis: A State-of-the-Art Systematic Review

Background: COVID-19 was initially considered to be a respiratory illness, but current findings suggest that SARS-CoV-2 is increasingly expressed in cardiac myocytes as well. COVID-19 may lead to cardiovascular injuries, resulting in myocarditis, with inflammation of the heart muscle. Objective: Thi...

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Autores principales:	Vikash Jaiswal, Zouina Sarfraz, Azza Sarfraz, Dattatreya Mukherjee, Nitya Batra, Gazala Hitawala, Sadia Yaqoob, Abhinav Patel, Preeti Agarwala, Ruchika, Muzna Sarfraz, Shehar Bano, Nishwa Azeem, Sidra Naz, Akash Jaiswal, Prachi Sharma, Gaurav Chaudhary
Formato:	article
Lenguaje:	EN
Publicado:	SAGE Publishing 2021
Materias:	Computer applications to medicine. Medical informatics R858-859.7 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/56cbe7c3c8bd4b2a87eac2d5878feb01
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spelling	oai:doaj.org-article:56cbe7c3c8bd4b2a87eac2d5878feb012021-12-02T23:33:48ZCOVID-19 Infection and Myocarditis: A State-of-the-Art Systematic Review2150-132710.1177/21501327211056800https://doaj.org/article/56cbe7c3c8bd4b2a87eac2d5878feb012021-12-01T00:00:00Zhttps://doi.org/10.1177/21501327211056800https://doaj.org/toc/2150-1327Background: COVID-19 was initially considered to be a respiratory illness, but current findings suggest that SARS-CoV-2 is increasingly expressed in cardiac myocytes as well. COVID-19 may lead to cardiovascular injuries, resulting in myocarditis, with inflammation of the heart muscle. Objective: This systematic review collates current evidence about demographics, symptomatology, diagnostic, and clinical outcomes of COVID-19 infected patients with myocarditis. Methods: In accordance with PRISMA 2020 guidelines, a systematic search was conducted using PubMed, Cochrane Central, Web of Science and Google Scholar until August, 2021. A combination of the following keywords was used: SARS-CoV-2, COVID-19, myocarditis. Cohorts and case reports that comprised of patients with confirmed myocarditis due to COVID-19 infection, aged >18 years were included. The findings were tabulated and subsequently synthesized. Results: In total, 54 case reports and 5 cohorts were identified comprising 215 patients. Hypertension (51.7%), diabetes mellitus type 2 (46.4%), cardiac comorbidities (14.6%) were the 3 most reported comorbidities. Majority of the patients presented with cough (61.9%), fever (60.4%), shortness of breath (53.2%), and chest pain (43.9%). Inflammatory markers were raised in 97.8% patients, whereas cardiac markers were elevated in 94.8% of the included patients. On noting radiographic findings, cardiomegaly (32.5%) was the most common finding. Electrocardiography testing obtained ST segment elevation among 44.8% patients and T wave inversion in 7.3% of the sample. Cardiovascular magnetic resonance imaging yielded 83.3% patients with myocardial edema, with late gadolinium enhancement in 63.9% patients. In hospital management consisted of azithromycin (25.5%), methylprednisolone/steroids (8.5%), and other standard care treatments for COVID-19. The most common in-hospital complication included acute respiratory distress syndrome (66.4%) and cardiogenic shock (14%). On last follow up, 64.7% of the patients survived, whereas 31.8% patients did not survive, and 3.5% were in the critical care unit. Conclusion: It is essential to demarcate COVID-19 infection and myocarditis presentations due to the heightened risk of death among patients contracting both myocardial inflammation and ARDS. With a multitude of diagnostic and treatment options available for COVID-19 and myocarditis, patients that are under high risk of suspicion for COVID-19 induced myocarditis must be appropriately diagnosed and treated to curb co-infections.Vikash JaiswalZouina SarfrazAzza SarfrazDattatreya MukherjeeNitya BatraGazala HitawalaSadia YaqoobAbhinav PatelPreeti Agarwala RuchikaMuzna SarfrazShehar BanoNishwa AzeemSidra NazAkash JaiswalPrachi SharmaGaurav ChaudharySAGE PublishingarticleComputer applications to medicine. Medical informaticsR858-859.7Public aspects of medicineRA1-1270ENJournal of Primary Care & Community Health, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Computer applications to medicine. Medical informatics R858-859.7 Public aspects of medicine RA1-1270
spellingShingle	Computer applications to medicine. Medical informatics R858-859.7 Public aspects of medicine RA1-1270 Vikash Jaiswal Zouina Sarfraz Azza Sarfraz Dattatreya Mukherjee Nitya Batra Gazala Hitawala Sadia Yaqoob Abhinav Patel Preeti Agarwala Ruchika Muzna Sarfraz Shehar Bano Nishwa Azeem Sidra Naz Akash Jaiswal Prachi Sharma Gaurav Chaudhary COVID-19 Infection and Myocarditis: A State-of-the-Art Systematic Review
description	Background: COVID-19 was initially considered to be a respiratory illness, but current findings suggest that SARS-CoV-2 is increasingly expressed in cardiac myocytes as well. COVID-19 may lead to cardiovascular injuries, resulting in myocarditis, with inflammation of the heart muscle. Objective: This systematic review collates current evidence about demographics, symptomatology, diagnostic, and clinical outcomes of COVID-19 infected patients with myocarditis. Methods: In accordance with PRISMA 2020 guidelines, a systematic search was conducted using PubMed, Cochrane Central, Web of Science and Google Scholar until August, 2021. A combination of the following keywords was used: SARS-CoV-2, COVID-19, myocarditis. Cohorts and case reports that comprised of patients with confirmed myocarditis due to COVID-19 infection, aged >18 years were included. The findings were tabulated and subsequently synthesized. Results: In total, 54 case reports and 5 cohorts were identified comprising 215 patients. Hypertension (51.7%), diabetes mellitus type 2 (46.4%), cardiac comorbidities (14.6%) were the 3 most reported comorbidities. Majority of the patients presented with cough (61.9%), fever (60.4%), shortness of breath (53.2%), and chest pain (43.9%). Inflammatory markers were raised in 97.8% patients, whereas cardiac markers were elevated in 94.8% of the included patients. On noting radiographic findings, cardiomegaly (32.5%) was the most common finding. Electrocardiography testing obtained ST segment elevation among 44.8% patients and T wave inversion in 7.3% of the sample. Cardiovascular magnetic resonance imaging yielded 83.3% patients with myocardial edema, with late gadolinium enhancement in 63.9% patients. In hospital management consisted of azithromycin (25.5%), methylprednisolone/steroids (8.5%), and other standard care treatments for COVID-19. The most common in-hospital complication included acute respiratory distress syndrome (66.4%) and cardiogenic shock (14%). On last follow up, 64.7% of the patients survived, whereas 31.8% patients did not survive, and 3.5% were in the critical care unit. Conclusion: It is essential to demarcate COVID-19 infection and myocarditis presentations due to the heightened risk of death among patients contracting both myocardial inflammation and ARDS. With a multitude of diagnostic and treatment options available for COVID-19 and myocarditis, patients that are under high risk of suspicion for COVID-19 induced myocarditis must be appropriately diagnosed and treated to curb co-infections.
format	article
author	Vikash Jaiswal Zouina Sarfraz Azza Sarfraz Dattatreya Mukherjee Nitya Batra Gazala Hitawala Sadia Yaqoob Abhinav Patel Preeti Agarwala Ruchika Muzna Sarfraz Shehar Bano Nishwa Azeem Sidra Naz Akash Jaiswal Prachi Sharma Gaurav Chaudhary
author_facet	Vikash Jaiswal Zouina Sarfraz Azza Sarfraz Dattatreya Mukherjee Nitya Batra Gazala Hitawala Sadia Yaqoob Abhinav Patel Preeti Agarwala Ruchika Muzna Sarfraz Shehar Bano Nishwa Azeem Sidra Naz Akash Jaiswal Prachi Sharma Gaurav Chaudhary
author_sort	Vikash Jaiswal
title	COVID-19 Infection and Myocarditis: A State-of-the-Art Systematic Review
title_short	COVID-19 Infection and Myocarditis: A State-of-the-Art Systematic Review
title_full	COVID-19 Infection and Myocarditis: A State-of-the-Art Systematic Review
title_fullStr	COVID-19 Infection and Myocarditis: A State-of-the-Art Systematic Review
title_full_unstemmed	COVID-19 Infection and Myocarditis: A State-of-the-Art Systematic Review
title_sort	covid-19 infection and myocarditis: a state-of-the-art systematic review
publisher	SAGE Publishing
publishDate	2021
url	https://doaj.org/article/56cbe7c3c8bd4b2a87eac2d5878feb01
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COVID-19 Infection and Myocarditis: A State-of-the-Art Systematic Review

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