Key result
SARS-CoV-2 infection is associated with variable cardiac pathology, and a review of over 40 cases proposes mechanisms for small troponin elevations in COVID-19 patients.
Why the study?
The nature and extent of cardiac pathology in COVID-19 remained controversial, including unclear etiologies of small troponin elevations and variable reports of myocarditis.
This review and case series explores the pathological changes in the heart due to COVID-19 and proposes mechanisms for the commonly observed troponin elevations.
Troponin monitoring may refine COVID-19 risk stratification; leaves open mechanisms of non-ischemic myocardial injury.
The SARS-CoV-2 virus has resulted in over 88 million cases worldwide of COVID-19 as of January 2021. The heart is one of the most commonly affected organs in COVID-19, but the nature and extent of the cardiac pathology has remained controversial. It has been shown that patients infected with SARS-CoV-2 can sustain type 1 myocardial infarction in the absence of significant atherosclerotic coronary artery disease. However, many patients present with small elevations of troponin enzymes of unclear etiology which correlate with overall COVID-19 disease outcome. Early autopsy reports indicated variable levels of typical lymphocytic myocarditis, while radiology reports have indicated that myocarditis can be a persistent problem after recovery from acute illness, raising concern about participation in college athletics. In this communication, we review the literature to date regarding the gross and microscopic findings of COVID-19 cardiac involvement, present the findings from over 40 cases from our academic medical center, and propose mechanisms by which patients develop small elevations in troponin. .
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Fox et al. (2021) conducted a review in COVID-19 (n=40). SARS-CoV-2 infection was evaluated on Gross and microscopic findings of COVID-19 cardiac involvement. SARS-CoV-2 infection is associated with variable cardiac pathology, and a review of over 40 cases proposes mechanisms for small troponin elevations in COVID-19 patients.
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