Key result
Triple therapy with colchicine, ibuprofen, and prednisolone resolves COVID-19-associated myopericarditis and myositis.
Why the study?
Concurrent myopericarditis and myositis can occur in systemic inflammatory diseases, but its presentation associated with COVID-19 without respiratory symptoms had not been reported.
Case Report (n=1)
COVID-19 can present with concurrent myopericarditis and myositis without respiratory symptoms, and responds to conventional anti-inflammatory therapy.
May support anti-inflammatory therapy in atypical COVID-19 myopericarditis-myositis; hypothesis-generating pending controlled trials.
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.
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Shabbir et al. (2020) conducted a case report in COVID-19 associated myopericarditis and myositis (n=1). Colchicine, ibuprofen, and prednisolone was evaluated on Symptom resolution and reduction of biochemical markers of inflammation. Therapy with colchicine, ibuprofen, and prednisolone effectively relieved symptoms, improved muscle function, and reduced biochemical markers of inflammation in COVID-19-associated myopericarditis and myositis.
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