News • Autopsy study

Myocarditis linked to COVID-19 not as common as believed

A study conducted by Richard Vander Heide, MD, PhD, Professor and Director of Pathology Research at LSU Health New Orleans School of Medicine, and Marc Halushka, MD, PhD, Professor of Pathology at Johns Hopkins University School of Medicine, suggests myocarditis caused by COVID-19 may be a relatively rare occurrence.

Photo
Source: NIAID, Novel Coronavirus SARS-CoV-2 (49679608341), CC BY 2.0

Reports of the rate of COVID-19 myocarditis have varied widely, ranging from 60% among middle-aged and elderly recovered patients to 14% among recovered athletes. “Although it is clear that COVID-19 impacts the heart and blood vessels, to date, it has been difficult to know how reproducible any changes are due to the relatively small sample size of most autopsy series,” notes Dr. Vander Heide.

The authors collected data from 277 autopsy cases to analyze cardiovascular pathological findings from patients who died from COVID-19 in nine countries around the world. The data from these autopsied hearts were published in 22 papers. After careful review, the authors determined that the rate of myocarditis found in these patients is between 1.4% and 7.2%.
“What we have learned is that myocarditis is not nearly as frequent in COVID-19 as has been thought,” says Dr. Halushka. “This finding should be useful for our clinical colleagues to reconsider how to interpret blood tests and heart radiology studies.”

“By bringing the data together from this large number of autopsy cases, we have better determined the spectrum of histologic findings,” adds Dr. Vander Heide. “Even a low myocarditis rate of 1.4% would predict hundreds of thousands of worldwide cases of myocarditis in severe COVID-19 due to the enormous numbers of infected individuals. Low rates of myocarditis do not indicate that individuals infected with SARS-CoV-2 are not having cardiovascular problems, but rather those complications are likely due to other stressors such as endothelial cell activation, cytokine storms, or electrolyte imbalances.”

The authors also created a “checklist” for pathologists to use going forward when evaluating COVID-19 at autopsy to provide consistency in investigating and reporting findings. “This study demonstrates the importance of the autopsy in helping us determine what is occurring in the hearts of individuals passing away due to COVID-19,” concludes Dr. Halushka.

Their findings are published in Cardiovascular Pathology.

Source: Louisiana State University Health Sciences Center

03.11.2020

More on the subject:

Related articles

Photo

News • Coronavirus research

Increased risk of heart rhythm disruption after Covid-19

A new, large-scale study from Sweden underlines the importance of vaccination against Covid-19: The research shows that an infection raises the risk of heart rhythm disturbances.

Photo

News • Cardiology research

Are hearts from Covid-19 positive donors safe for transplantation?

Donor hearts from people who were Covid-19-positive appear to be as safe for transplantation as those from people without Covid-19, according to a new short-term analysis.

Photo

News • Heart muscle inflammation

Covid-19 infection increases myocarditis risk (a lot more than the vaccine does)

The overall risk of myocarditis is substantially higher immediately after being infected with Covid-19 than it is in the weeks following vaccination for the coronavirus, a large new study shows.

Related products

Subscribe to Newsletter