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Clinical and Histopathologic Features of Myocarditis in Multisystem Inflammatory Syndrome (Adult)–Associated COVID-19
BACKGROUND: Multisystem inflammatory syndrome (MIS) associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is a life-threatening condition first described in children (MIS-C). It is characterized by a hyperinflammatory state that involves the cardiovascular, gastroint...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Lippincott Williams & Wilkins
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8860337/ https://www.ncbi.nlm.nih.gov/pubmed/35211680 http://dx.doi.org/10.1097/CCE.0000000000000630 |
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author | Aldeghaither, Saud Qutob, Rayan Assanangkornchai, Nawaporn Issa-Chergui, Badia Tam, May Larotondo, Rita Samoukovic, Gordan |
author_facet | Aldeghaither, Saud Qutob, Rayan Assanangkornchai, Nawaporn Issa-Chergui, Badia Tam, May Larotondo, Rita Samoukovic, Gordan |
author_sort | Aldeghaither, Saud |
collection | PubMed |
description | BACKGROUND: Multisystem inflammatory syndrome (MIS) associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is a life-threatening condition first described in children (MIS-C). It is characterized by a hyperinflammatory state that involves the cardiovascular, gastrointestinal, dermatologic, and neurologic systems without severe respiratory system involvement. Myocarditis is one of the cardiovascular presentations of MIS that might be complicated with cardiogenic shock. There are few case reports describing SARS-CoV-2-related MIS in adults (MIS-A). CASE SUMMARY: Three cases of healthy young adults diagnosed with severe acute respiratory syndrome-CoV-2 related (MIS-A). The main presentation was cardiogenic shock secondary to histologically proven myocarditis, which resolved rapidly after initiation of medical therapy including anti-inflammatory and immunosuppressive drugs. All the cases, however, required mechanical circulatory support (MCS) as a bridge to recovery. CONCLUSIONS: It appears reasonable to treat the patient with fulminant myocarditis in SARS-CoV-2-associated MIS-A with high-dose corticosteroid “pulse” therapy in order to suppress the inflammatory response and MCS to correct initial metabolic derangement and reestablish/maintain vital organ perfusion. Addition of IV immunoglobulin and other immunomodulators should be assessed in a case-by-case basis especially considering the associated cost resource allocation. |
format | Online Article Text |
id | pubmed-8860337 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-88603372022-02-23 Clinical and Histopathologic Features of Myocarditis in Multisystem Inflammatory Syndrome (Adult)–Associated COVID-19 Aldeghaither, Saud Qutob, Rayan Assanangkornchai, Nawaporn Issa-Chergui, Badia Tam, May Larotondo, Rita Samoukovic, Gordan Crit Care Explor Case Report BACKGROUND: Multisystem inflammatory syndrome (MIS) associated with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is a life-threatening condition first described in children (MIS-C). It is characterized by a hyperinflammatory state that involves the cardiovascular, gastrointestinal, dermatologic, and neurologic systems without severe respiratory system involvement. Myocarditis is one of the cardiovascular presentations of MIS that might be complicated with cardiogenic shock. There are few case reports describing SARS-CoV-2-related MIS in adults (MIS-A). CASE SUMMARY: Three cases of healthy young adults diagnosed with severe acute respiratory syndrome-CoV-2 related (MIS-A). The main presentation was cardiogenic shock secondary to histologically proven myocarditis, which resolved rapidly after initiation of medical therapy including anti-inflammatory and immunosuppressive drugs. All the cases, however, required mechanical circulatory support (MCS) as a bridge to recovery. CONCLUSIONS: It appears reasonable to treat the patient with fulminant myocarditis in SARS-CoV-2-associated MIS-A with high-dose corticosteroid “pulse” therapy in order to suppress the inflammatory response and MCS to correct initial metabolic derangement and reestablish/maintain vital organ perfusion. Addition of IV immunoglobulin and other immunomodulators should be assessed in a case-by-case basis especially considering the associated cost resource allocation. Lippincott Williams & Wilkins 2022-02-18 /pmc/articles/PMC8860337/ /pubmed/35211680 http://dx.doi.org/10.1097/CCE.0000000000000630 Text en Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Case Report Aldeghaither, Saud Qutob, Rayan Assanangkornchai, Nawaporn Issa-Chergui, Badia Tam, May Larotondo, Rita Samoukovic, Gordan Clinical and Histopathologic Features of Myocarditis in Multisystem Inflammatory Syndrome (Adult)–Associated COVID-19 |
title | Clinical and Histopathologic Features of Myocarditis in Multisystem Inflammatory Syndrome (Adult)–Associated COVID-19 |
title_full | Clinical and Histopathologic Features of Myocarditis in Multisystem Inflammatory Syndrome (Adult)–Associated COVID-19 |
title_fullStr | Clinical and Histopathologic Features of Myocarditis in Multisystem Inflammatory Syndrome (Adult)–Associated COVID-19 |
title_full_unstemmed | Clinical and Histopathologic Features of Myocarditis in Multisystem Inflammatory Syndrome (Adult)–Associated COVID-19 |
title_short | Clinical and Histopathologic Features of Myocarditis in Multisystem Inflammatory Syndrome (Adult)–Associated COVID-19 |
title_sort | clinical and histopathologic features of myocarditis in multisystem inflammatory syndrome (adult)–associated covid-19 |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8860337/ https://www.ncbi.nlm.nih.gov/pubmed/35211680 http://dx.doi.org/10.1097/CCE.0000000000000630 |
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