Goette Andreas, Patscheke Markus, Henschke Frank, Hammwöhner Matthias
Department of Cardiology and Intensive Care Medicine, St. Vincenz Hospital, Paderborn, Germany.
Working Group: Molecular Electrophysiology, University Hospital Magdeburg, Magdeburg, Germany.
TH Open. 2020 Sep 26;4(3):e271-e279. doi: 10.1055/s-0040-1716717. eCollection 2020 Jul.
Coronavirus disease 2019 (COVID-19) is a viral disease induced by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), which may cause an acute respiratory distress syndrome (ARDS). First reports have shown that elevated levels of inflammatory cytokines might be involved in the development of organ dysfunction in COVID-19. Here, we can present a case of cytokine release syndrome induced by SARS-CoV-2 causing multiorgan failure and death. Of note, we can report on pulmonary vein thromboses as potential source of cerebrovascular embolic events. Furthermore, we present a specific form of an isolated inflammatory atrial cardiomyopathy encompassing atrial myocardium, perivascular matrix, as well as atrial autonomic nerve ganglia, causing atrial fibrillation, sinus node arrest, as well as atrial clot formation in the right atrial appendage. An associated acute glomerulonephritis caused acute kidney failure. Furthermore, all the described pathologies of organs and vessels were associated with increased local expression of interleukin-6 and monocyte chemoattractant protein-1 (MCP-1). This report provides new evidence about fatal pathologies and summarizes the current knowledge about organ manifestations observed in COVID-19.
2019冠状病毒病（COVID-19）是一种由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的病毒性疾病，可能导致急性呼吸窘迫综合征（ARDS）。初步报告显示，炎症细胞因子水平升高可能与COVID-19患者器官功能障碍的发生有关。在此，我们报告一例由SARS-CoV-2引起的细胞因子释放综合征导致多器官衰竭和死亡的病例。值得注意的是，我们报告了肺静脉血栓形成可能是脑血管栓塞事件的潜在来源。此外，我们还展示了一种孤立性炎症性心房心肌病的特殊形式，其累及心房心肌、血管周围基质以及心房自主神经节，导致心房颤动、窦房结停搏以及右心耳心房血栓形成。相关的急性肾小球肾炎导致急性肾衰竭。此外，所有所描述的器官和血管病变均与白细胞介素-6和单核细胞趋化蛋白-1（MCP-1）的局部表达增加有关。本报告提供了关于致命病变的新证据，并总结了目前关于COVID-19中观察到的器官表现的知识。
