Çınar Tufan, Hayıroğlu Mert İlker, Çiçek Vedat, Uzun Mehmet, Orhan Ahmet Lütfullah
. Department of Cardiology, Haydarpasa Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
. Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey.
Rev Assoc Med Bras (1992). 2020 Sep 21;66Suppl 2(Suppl 2):48-54. doi: 10.1590/1806-9282.66.S2.48. eCollection 2020.
In the current literature, there has been an upsurge of cases of COVID-19-induced acute myocarditis. In this case-based review, we aimed to describe the clinical characteristics, imaging findings, and in-hospital course of acute myocarditis. In addition, the limitations of the myocarditis diagnosis were discussed since only fulminant myocarditis cases have been mentioned in the current literature.
We performed a review of the literature of all patients who were diagnosed with COVID-19-induced acute myocarditis using the databases of PubMed, Embase, and the Cochrane.
16 case reports were found to be related to COVID-19-induced acute myocarditis. We observed that the ECG findings in most of the COVID-19 patients were non-specific, including diffuse ST-segment elevation, non-specific intraventricular conduction delay, sinus tachycardia, and inverted T-waves in anterior leads. Echocardiographic findings of COVID-19-induced acute myocarditis patients ranged from preserved left ventricular ejection fraction (LVEF) without segmental abnormalities to reduced LVEF with global hypokinesia. Interestingly, a few patients with COVID-19-induced acute fulminant myocarditis were steroid-responsive and had an amelioration with glucocorticoid and immunoglobulin therapy.
Despite the COVID-19 pandemic worldwide, a limited number of cases has been shared in the current literature. There are a lot of difficulties in the differential diagnosis of acute myocarditis in the context of COVID-19.
在当前文献中，由新冠病毒感染引起的急性心肌炎病例激增。在本病例回顾中，我们旨在描述急性心肌炎的临床特征、影像学表现及住院病程。此外，鉴于当前文献仅提及暴发性心肌炎病例，我们还讨论了心肌炎诊断的局限性。
我们使用PubMed、Embase和Cochrane数据库，对所有被诊断为新冠病毒感染引起的急性心肌炎患者的文献进行了回顾。
发现16例病例报告与新冠病毒感染引起的急性心肌炎有关。我们观察到，大多数新冠病毒感染患者的心电图表现无特异性，包括弥漫性ST段抬高、非特异性室内传导延迟、窦性心动过速以及前壁导联T波倒置。新冠病毒感染引起的急性心肌炎患者的超声心动图表现范围从左心室射血分数（LVEF）正常且无节段性异常到LVEF降低且整体运动减弱。有趣的是，少数新冠病毒感染引起的急性暴发性心肌炎患者对类固醇治疗有反应，糖皮质激素和免疫球蛋白治疗后病情有所改善。
尽管全球范围内爆发了新冠疫情，但当前文献中报道的病例数量有限。在新冠病毒感染背景下，急性心肌炎的鉴别诊断存在诸多困难。
