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[Miocarditis in Patients with COVID-19 Confirmed by Immunohistochemical].

作者信息

Kogan E A, Berezovskiy Yu S, Blagova O V, Kukleva A D, Bogacheva G A, Kurilina E V, Kalinin D V, Bagdasaryan T R, Semeyonova L A, Gretsov E M, Ergeshov A E, Fomin V V

机构信息

Sechenov Fist Moscow State Medical University (Sechenov University), Moscow, Russia.

Central Tuberculosis Research Institute, Moscow, Russia.

出版信息

Kardiologiia. 2020 Jun 19;60(7):4-10. doi: 10.18087/cardio.2020.7.n1209.


DOI:10.18087/cardio.2020.7.n1209
PMID:33155934
Abstract

Aim      Despite the regular heart damage in patients with coronavirus pneumonia caused by SARS-Cov-2, a possibility of developing lymphocytic myocarditis as a part of COVID-19 remains unsubstantiated. The aim of this study was to demonstrate a possibility of lymphocytic myocarditis and to study its morphological features in patients with the novel coronavirus infection (COVID-19) with a severe course.Material and methods   Postmortem data were studied for 5 elderly patients (74.8±4.4 years; 3 men and 2 women) with the novel coronavirus infection and bilateral, severe polysegmental pneumonia (stage 3-4 by computed tomography). COVID-19 was diagnosed based on the typical clinical presentation and positive polymerase chain reaction test in nasopharyngeal swabs. All patients were treated in different hospitals repurposed for the treatment of patients with COVID-19. A standard histological study was performed with hematoxylin and eosin, toluidine blue, and van Gieson staining. Serial paraffin slices were studied immunohistochemically with antibodies to CD3, СD68, CD20, perforin, and toll-like receptors (TLR) 4 and 9.Results In none of the cases, myocarditis was suspected clinically, added to the diagnosis or indicated as a possible cause of death. IHD and acute myocardial infarction were mentioned as error diagnoses not confirmed by the postmortem examination. The morphological examination of the heart identified signs of lymphocytic myocarditis consistent with Dallas criteria for this diagnosis. Myocardial infiltrate was characterized in detail, and a combined inflammatory damage of endocardium and pericardium was described. The immunohistochemical study with cell infiltrate typing confirmed the presence of CD3-positive Т lymphocytes and the increased expression of TLR-4. A picture of coronaritis, including that with microvascular thrombosis, was found in all cases.Conclusion      A possibility for development of lymphocytic viral myocarditis in COVID-19 was confirmed morphologically and immunohistochemically. Specific features of myocarditis in COVID-19 include the presence of coronaritis and a possible combination of myocarditis with lymphocytic endo- and pericarditis.

摘要

相似文献

[1]
[Miocarditis in Patients with COVID-19 Confirmed by Immunohistochemical].

Kardiologiia. 2020-6-19

[2]
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[3]
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[4]
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[5]
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Cardiovasc Res. 2020-8-1

[6]
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[7]
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[8]
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Pol Arch Intern Med. 2020-5-29

[9]
Thoracic imaging tests for the diagnosis of COVID-19.

Cochrane Database Syst Rev. 2020-9-30

[10]
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引用本文的文献

[1]
Spectrum of Non-Obstructive Coronary Artery Disease and Its Relationship with Atrial Fibrillation.

J Clin Med. 2024-8-21

[2]
Toll-like receptor (TLRs) agonists and antagonists for COVID-19 treatments.

Front Pharmacol. 2022-9-7

[3]
Chronic biopsy proven post-COVID myoendocarditis with SARS-Cov-2 persistence and high level of antiheart antibodies.

Clin Cardiol. 2022-9

[4]
Previous and First Detected Cardiovascular Diseases in Patients with New Coronavirus Pneumonia: Possible Mechanisms and Place in a Unified Prognostic Model.

Int Arch Allergy Immunol. 2021

[5]
Troponin-T and B-Type Natriuretic Peptide in COVID-19.

Arq Bras Cardiol. 2021-4

[6]
COVID-19 and Toll-Like Receptor 4 (TLR4): SARS-CoV-2 May Bind and Activate TLR4 to Increase ACE2 Expression, Facilitating Entry and Causing Hyperinflammation.

Mediators Inflamm. 2021

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