REVIEW ARTICLE


COVID-19 Cardiac Complication- Myocarditis



Lana Maričić1, 2, *, Damir Mihić1, 2, Livija Sušić2, 3, Domagoj Loinjak1, 2
1 Department of Internal Medicine, University Hospital Osijek, Osijek, Croatia
2 Faculty of Medicine, University J.J Strossmayera Osijek, Osijek, Croatia
3 Health Center Osijek, Osijek, Croatia


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Creative Commons License
© 2021 Maričić et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: https://creativecommons.org/licenses/by/4.0/legalcode. This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at Department of Internal Medicine, University Hospital Osijek, J.Huttlera 4, 31000 Osijek, Croatia; Tel: +38531511742; E-mail: dr.lmaricic@gmail.com


Abstract

Based on the clinical experience, it has been observed that when it comes to the impact of SARS-CoV-2 virus on the cardiovascular system, it is significant. In patients with COVID-19 infection, the development of myocarditis occurs a few days after the onset of fever. The mechanism of myocardial injury alone, as well as most pathologies caused by the SARS-CoV-2 virus, is the subject of research by many experts, but two basic ways can certainly be assumed: a direct toxic effect of SARS-CoV-2 on myocardial cells and another possible way of myocardial injury is to activate the innate immune response by releasing proinflammatory cytokines, as well as to activate the adaptive mechanisms of the autoimmune type by molecular mimicry. The approach to treatment is the same as for other viral myocarditis; it is non-specific, applied supportive treatment, such as anti-inflammatory drugs, low-dose corticosteroid therapy, and immunoglobulins. The aim of this review is to present the previous experiences of physicians around the world on the clinical presentation of myocarditis caused by COVID-19 infection, diagnostic and therapeutic approach in a specific situation of high-risk infection.

Keywords: Myocarditis, COVID-19, Cardiovascular disease, Angiotensin-converting enzyme-2, Acute cardiac injury, Case study.