与心肌炎和持续性心律失常相关的心脏组织中严重急性呼吸综合征冠状病毒2的检测与测序：病例报告
SARS-CoV-2 detection and sequencing in heart tissue associated with myocarditis and persistent arrhythmia: A case report.
作者信息
Egas Diego, Guadalupe Juan José, Prado-Vivar Belén, Becerra-Wong Mónica, Márquez Sully, Castillo Stalin, Latta Johanna, Rodriguez Francisco, Escorza Giovanni, Trueba Gabriel, Grunauer Michelle, Barragán Verónica, Rojas-Silva Patricio, Cárdenas Paúl
机构信息
Hospital Quito N° 1 de la Policía Nacional, Quito, Ecuador.
Universidad San Francisco de Quito, COCIBA, Laboratorio de Biotecnología Vegetal, Quito, Ecuador.
出版信息
IDCases. 2021;25:e01187. doi: 10.1016/j.idcr.2021.e01187. Epub 2021 Jun 11.
BACKGROUND
SARS-CoV-2 uses the human cell receptor angiotensin-converting enzyme (ACE2). ACE2 is widely present in the cardiovascular system including the myocardium and the conduction system. COVID-19 patients that present severe symptoms have been reported to have complications involving myocardial injuries caused by the virus. Here we report the detection of SARS-CoV-2 by whole genome sequencing in the endocardium of a patient with severe bradycardia.
CASE PRESENTATION
We report a case of a 34-year-old male patient with COVID-19 tested by PCR, he started with gastrointestinal symptoms, however, he quickly deteriorated his hemodynamic state by means of myocarditis and bradycardia. After performing an endocardium biopsy, it was possible to identify the presence of SARS-CoV-2 in the heart tissue and to sequence its whole genome using the ARTIC-Network protocol and a modified tissue RNA extraction method. The patient's outcome was improved after a permanent pacemaker was implanted.
CONCLUSIONS
It was possible to identify a SARS-CoV-2 clade 20A in the endocardium of the reported patient.
背景
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）利用人类细胞受体血管紧张素转换酶（ACE2）。ACE2广泛存在于包括心肌和传导系统在内的心血管系统中。据报道，出现严重症状的2019冠状病毒病（COVID-19）患者有涉及病毒引起的心肌损伤的并发症。在此，我们报告通过全基因组测序在一名严重心动过缓患者的心内膜中检测到SARS-CoV-2。
病例介绍
我们报告一例34岁男性COVID-19患者，经聚合酶链反应（PCR）检测，他最初出现胃肠道症状，然而，他因心肌炎和心动过缓迅速出现血流动力学状态恶化。在进行心内膜活检后，有可能在心脏组织中鉴定出SARS-CoV-2的存在，并使用ARTIC网络方案和改良的组织RNA提取方法对其全基因组进行测序。植入永久性起搏器后患者的病情得到改善。
结论
在所报告患者的心内膜中鉴定出一个SARS-CoV-2 20A分支。
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