What is the clinical evidence from this study?

Study design: Case Report. Population: COVID-19 with concurrent myopericarditis and myositis (n=1). Intervention: Colchicine, ibuprofen, and prednisolone. Primary outcome: Symptom improvement and reduction of biochemical markers.

October 30, 2020Open Access

Myopericarditis and myositis in a patient with COVID-19: a case report

Key Result

Treatment with colchicine, ibuprofen, and prednisolone improved symptoms and reduced biochemical markers of myocardial and skeletal muscle inflammation in a patient with COVID-19.

Study Design

Type

Case Report (n=1)

Structured PICO

Population

1 middle-aged female with COVID-19 presenting with concurrent myopericarditis and myositis.

Intervention

Colchicine 500 μg twice daily, ibuprofen 400 mg three times day, and prednisolone 30 mg per day

Outcome

Symptom improvement and reduction of biochemical markers of myocardial and skeletal muscle inflammation

COVID-19 can present with concurrent myopericarditis and myositis without respiratory symptoms, and responds to conventional anti-inflammatory therapy.

Abstract

BACKGROUND: Concurrent myopericarditis and myositis can present in patients with pre-existing systemic inflammatory diseases. Here we present a case of myopericarditis and myositis associated with COVID-19, in the absence of respiratory symptoms. CASE SUMMARY: We present a middle-aged female with a history of hypertension and previous myopericarditis. The patient was admitted with symptoms of central chest pain, and ECG and echocardiographic features of myopericarditis. Her symptoms did not improve, and CT thorax suggested possible SARS-CoV-2 infection for which she tested positive, despite no respiratory symptoms. Whilst on the ward, she developed bilateral leg weakness and a raised creatine kinase (CK), and magnetic resonance imaging (MRI) of her thighs confirmed myositis. A cardiac MRI confirmed myopericarditis. She was treated with colchicine 500 μg twice daily, ibuprofen 400 mg three times day, and prednisolone 30 mg per day, and her symptoms and weakness improved. DISCUSSION: We describe the first reported case of concurrent myopericarditis, and myositis associated with COVID-19. Conventional therapy with colchicine, non-steroidal anti-inflammatory drugs, and glucocorticoids improved her symptoms, and reduced biochemical markers of myocardial and skeletal muscle inflammation.