Pirzada Ashar, Mokhtar Ahmed T, Moeller Andrew D
Division of Cardiology, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada.
Department of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
CJC Open. 2020 May 28;2(4):278-285. doi: 10.1016/j.cjco.2020.05.005. eCollection 2020 Jul.
COVID-19 has been declared a global pandemic by the World Health Organization and is responsible for hundreds of thousands of deaths worldwide. COVID-19 is caused by SARS-CoV-2, and common clinical symptoms include fever, cough, sore throat, headache, and fatigue. Myocardial injury is relatively common in patients with COVID-19, accounting for 7%-23% of cases, and is associated with a higher rate of morbidity and mortality. There is a discrepancy in the literature about myocarditis as the etiology of myocardial injury in patients with COVID-19; although many anecdotal reports of myocarditis have been noted, there are only a handful of case reports in the literature about myocarditis related to COVID-19. In this review we summarize the most up to date literature around the association between COVID-19 and myocarditis and provide clinicians a practical framework about the clinical manifestations, diagnostic tools, and treatment options currently available. Importantly, this review will heighten suspicion for myocarditis as an etiology of myocardial injury in COVID-19 patients, therefore improving clinical outcomes and encouraging shared clinical decision-making. This will also open the door for further research to build around this review. Emergent treatment options for COVID-19 are in clinical trials and might be of benefit to COVID-19 patients with myocarditis in addition to current guideline-based recommendations.
世界卫生组织已宣布新型冠状病毒肺炎（COVID-19）为全球大流行病，其在全球造成了数十万人死亡。COVID-19由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起，常见临床症状包括发热、咳嗽、咽痛、头痛和疲劳。心肌损伤在COVID-19患者中较为常见，占病例的7%-23%，且与更高的发病率和死亡率相关。关于心肌炎作为COVID-19患者心肌损伤病因的文献存在差异；尽管已有许多关于心肌炎的传闻报道，但文献中仅有少数关于与COVID-19相关心肌炎的病例报告。在本综述中，我们总结了关于COVID-19与心肌炎关联的最新文献，并为临床医生提供了一个关于目前可用的临床表现、诊断工具和治疗选择的实用框架。重要的是，本综述将提高对心肌炎作为COVID-19患者心肌损伤病因的怀疑，从而改善临床结果并鼓励共同的临床决策制定。这也将为围绕本综述展开进一步研究打开大门。针对COVID-19的紧急治疗方案正在进行临床试验，除了目前基于指南的建议外，可能对患有心肌炎的COVID-19患者有益。
