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[通过心肌组织中病毒RNA和蛋白质的存在证实的与SARS-CoV-2相关的心肌炎的临床和形态学特征]

[Clinical and morphological characteristics of SARS-CoV-2-related myocarditis proven by the presence of viral RNA and proteins in myocardial tissue].

作者信息

Kogan E A, Kukleva A D, Berezovskiy Yu S, Blagova O V, Zharkov N V, Ainetdinova D Kh, Demyashkin G A

机构信息

I.M. Sechenov First Moscow State Medical University of the Ministry of Health of Russia, Moscow, Russia.

Central Research Institute of Tuberculosis, Moscow, Russia.

出版信息

Arkh Patol. 2021;83(4):5-13. doi: 10.17116/patol2021830415.

Abstract

OBJECTIVE

To investigate the clinical and morphological features of SARS-CoV-2-related myocarditis, by determining the presence of viral RNA and proteins in myocardial tissue.

MATERIAL AND METHODS

The study was conducted to examine the material of 32 autopsies with a confirmed diagnosis of myocarditis. There were data of a morphological study, including a standard histological study, as well as immunohistochemical determination of the surface markers CD45, CD3, CD20, and CD68 cells of an inflammatory infiltrate and virus proteins (SARS-CoV-2 nucleocapsid protein and spike protein). Positive and negative control tests were carried out. In addition, coronavirus RNA was detected in the myocardium using a polymerase chain reaction.

RESULTS

Polymerase chain reaction (PCR) revealed viral RNA in myocardial tissue. Viral proteins were identified in the macrophages of an inflammatory infiltrate and cardiomyocytes.

CONCLUSION

The findings may suggest that the virus persists in the myocardium and chronic myocarditis develops.

摘要

目的

通过测定心肌组织中病毒RNA和蛋白质的存在情况,研究新型冠状病毒肺炎相关心肌炎的临床和形态学特征。

材料与方法

本研究对32例确诊为心肌炎的尸检材料进行检查。有形态学研究数据,包括标准组织学研究,以及炎症浸润的表面标志物CD45、CD3、CD20和CD68细胞及病毒蛋白(新型冠状病毒核衣壳蛋白和刺突蛋白)的免疫组织化学测定。进行了阳性和阴性对照试验。此外,使用聚合酶链反应在心肌中检测冠状病毒RNA。

结果

聚合酶链反应(PCR)在心肌组织中检测到病毒RNA。在炎症浸润的巨噬细胞和心肌细胞中鉴定出病毒蛋白。

结论

这些发现可能表明病毒在心肌中持续存在并发展为慢性心肌炎。

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