Key result
COVID-19 infection and mRNA vaccinations are associated with myocarditis, with pathogenesis likely involving changes in ACE2 expression and exaggerated immune responses mediated by Toll-like receptors.
Why the study?
COVID-19 infection and mRNA vaccinations can cause myocarditis and myocardial injury associated with poorer outcomes, but the underlying pathophysiological mechanisms involving ACE2 and Toll-like receptors require clarification.
This review details the pathophysiological roles of ACE2 and Toll-like receptors in the development of myocarditis following COVID-19 infection or mRNA vaccination.
Post-COVID cardiac complications warrant vigilance in survivors; review extends systemic effects knowledge but leaves mechanisms and management unresolved.
The clinical manifestations of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection responsible for coronavirus disease 2019 (COVID-19) commonly include dyspnoea and fatigue, and they primarily involve the lungs. However, extra-pulmonary organ dysfunctions, particularly affecting the cardiovascular system, have also been observed following COVID-19 infection. In this context, several cardiac complications have been reported, including hypertension, thromboembolism, arrythmia and heart failure, with myocardial injury and myocarditis being the most frequent. These secondary myocardial inflammatory responses appear to be associated with a poorer disease course and increased mortality in patients with severe COVID-19. In addition, numerous episodes of myocarditis have been reported as a complication of COVID-19 mRNA vaccinations, especially in young adult males. Changes in the cell surface expression of angiotensin-converting enzyme 2 (ACE2) and direct injury to cardiomyocytes resulting from exaggerated immune responses to COVID-19 are just some of the mechanisms that may explain the pathogenesis of COVID-19-induced myocarditis. Here, we review the pathophysiological mechanisms underlying myocarditis associated with COVID-19 infection, with a particular focus on the involvement of ACE2 and Toll-like receptors (TLRs).
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Pannucci et al. (2023) conducted a review in COVID-19-induced myocarditis. COVID-19 infection was evaluated. COVID-19 infection and mRNA vaccinations are associated with myocarditis, with pathogenesis likely involving changes in ACE2 expression and exaggerated immune responses mediated by Toll-like receptors.
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