COVID-19 myocarditis and long-term heart failure sequelae : Current Opinion in Cardiology

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HEART FAILURE: Edited by Frank W. Smart

COVID-19 myocarditis and long-term heart failure sequelae

Liu, Jinga; Deswal, Anitab; Khalid, Umairc

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Current Opinion in Cardiology 36(2):p 234-240, March 2021. | DOI: 10.1097/HCO.0000000000000832

Abstract

Purpose of review 

The clinical syndrome of coronavirus disease 2019 (COVID-19) has become a global pandemic leading to significant morbidity and mortality. Cardiac dysfunction is commonly seen in these patients, often presenting as clinical heart failure. Accordingly, we aim to provide a comprehensive review on COVID-19 myocarditis and its long-term heart failure sequelae.

Recent findings 

Several suspected cases of COVID-19 myocarditis have been reported. It is often not clear if the acute myocardial dysfunction is caused by myocarditis or secondary to generalized inflammatory state of cytokine release or microvascular thrombotic angiopathy. Ischemia may also need to be ruled out. Regardless, myocardial dysfunction in these patients is associated with poor overall prognosis. Laboratory testing, echocardiography, cardiac magnetic resonance imaging, and even endomyocardial biopsy may be needed for timely diagnosis. Several treatment strategies have been described, including both supportive and targeted therapies.

Summary 

COVID-19 can cause a spectrum of ventricular dysfunction ranging from mild disease to fulminant myocarditis with hemodynamic instability. Future research is needed to understand the true prevalence of COVID-19 myocarditis, as well as to better define various diagnostic protocols and treatment strategies.

Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

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