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. |
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| Authors: | Aldeghaither S; Department of Critical Care Medicine, McGill University, Montreal, QC, Canada.; Department of Critical Care Medicine, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia.; Qutob R; Department of Critical Care Medicine, McGill University, Montreal, QC, Canada.; Faculty of Medicine, Department of Medicine, Imam Mohammad Ibn Saud Islamic University, Riyadh, Saudi Arabia.; Assanangkornchai N; Department of Critical Care Medicine, McGill University, Montreal, QC, Canada.; Faculty of Medicine, Department of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.; Issa-Chergui B; Department of Pathology, McGill University, Montreal, Quebec, QC, Canada.; Tam M; Perfusion Department, McGill University, Montreal, QC, Canada.; Larotondo R; Nursing Department, McGill University, Montreal, QC, Canada.; Samoukovic G; Department of Critical Care Medicine, McGill University, Montreal, QC, Canada. |
| Source: | Critical care explorations [Crit Care Explor] 2022 Feb 18; Vol. 10 (2), pp. e0630. Date of Electronic Publication: 2022 Feb 18 (Print Publication: 2022). |
| Publication Type: | Case Reports; Journal Article |
| Language: | English |
| Journal Info: | Publisher: Wolters Kluwer Health Country of Publication: United States NLM ID: 101746347 Publication Model: eCollection Cited Medium: Internet ISSN: 2639-8028 (Electronic) Linking ISSN: 26398028 NLM ISO Abbreviation: Crit Care Explor Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, PA : Wolters Kluwer Health, [2019]- |
| Abstract: | 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.; (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.) |
| Competing Interests: | The authors have disclosed that they do not have any potential conflicts of interest. |
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| Entry Date(s): | Date Created: 20220225 Latest Revision: 20220502 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC8860337 |
| DOI: | 10.1097/CCE.0000000000000630 |
| PMID: | 35211680 |
| Database: | MEDLINE |
Case Reports; Journal Article