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Detection of viral SARS-CoV-2 genomes and histopathological changes in endomyocardial biopsies
- Source :
- ESC Heart Failure, ESC Heart Failure, Vol 7, Iss 5, Pp 2440-2447 (2020)
- Publication Year :
- 2020
-
Abstract
- Aims Since December 2019, the novel coronavirus SARS‐CoV‐2 has spread rapidly throughout China and keeps the world in suspense. Cardiovascular complications with myocarditis and embolism due to COVID‐19 have been reported. SARS‐CoV‐2 genome detection in the heart muscle has not been demonstrated so far, and the underlying pathophysiological mechanisms remain to be investigated. Methods and results Endomyocardial biopsies (EMBs) of 104 patients (mean age: 57.90 ± 16.37 years; left ventricular ejection fraction: 33.7 ± 14.6%, sex: n = 79 male/25 female) with suspected myocarditis or unexplained heart failure were analysed. EMB analysis included histology, immunohistochemistry, and detection of SARS‐CoV‐2 genomes by real‐time reverse transcription polymerase chain reaction in the IKDT Berlin, Germany. Among 104 EMBs investigated, five were confirmed with SARS‐CoV‐2 infected by reverse real‐time transcriptase polymerase chain reaction. We describe patients of different history of symptoms and time duration. Additionally, we investigated histopathological changes in myocardial tissue showing that the inflammatory process in EMBs seemed to permeate vascular wall leading to small arterial obliteration and damage. Conclusions This is the first report that established the evidence of SARS‐CoV‐2 genomes detection in EMBs. In these patients, myocardial injury ischaemia may play a role, which could explain the ubiquitous troponin increases. EMB‐based identification of the cause of myocardial injury may contribute to explain the different evolution of complicated SARS‐CoV‐2‐infection and to design future specific and personalized treatment strategies.
- Subjects :
- Male
Pathology
030204 cardiovascular system & hematology
Communicable Diseases, Emerging
Disease Outbreaks
Cohort Studies
0302 clinical medicine
Germany
Original Research Articles
030212 general & internal medicine
Original Research Article
SARS‐CoV‐2‐infection
Ejection fraction
biology
Incidence
Biopsy, Needle
Age Factors
Genomics
Middle Aged
Immunohistochemistry
Reverse transcription polymerase chain reaction
Myocarditis
Severe acute respiratory syndrome-related coronavirus
Endomyocardial biopsy
Female
Cardiology and Cardiovascular Medicine
Coronavirus Infections
Adult
medicine.medical_specialty
Pneumonia, Viral
Ischemia
Heart failure
Real-Time Polymerase Chain Reaction
03 medical and health sciences
Sex Factors
COVID‐19
medicine
Diseases of the circulatory (Cardiovascular) system
Humans
Pandemics
Aged
Retrospective Studies
business.industry
COVID-19
medicine.disease
Troponin
Survival Analysis
Reverse transcriptase
Embolism
Gene Expression Regulation
RC666-701
biology.protein
business
Endocardium
Subjects
Details
- ISSN :
- 20555822
- Volume :
- 7
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- ESC heart failure
- Accession number :
- edsair.doi.dedup.....c1c75a522f8c481e349200bfe8d9134b