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COVID-19 acute myocarditis and Multisystem Inflammatory Syndrome in adult intensive and cardiac care units

Publié dans Chest 2020 Sep 7: S0012-3692(20)34359-2

Auteurs : Hékimian G, Kerneis M, Zeitouni M, Cohen-Aubart F, Chommeloux J, Bréchot N, Mathian A, Lebreton G, Schmidt M, Hié M, Silvain J, Pineton de Chambrun M, Haroche J, Burrel S, Marot S, Luyt CE, Leprince P, Amoura Z, Montalescot G, Redheuil A, Combes A.

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Abstract

Hyperinflammatory shock was recently described in children during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The clinical presentation of these patients involved fever, cutaneous rash, abdominal symptoms, distributive shock and acute cardiac injury. This multisystem inflammatory syndrome had similarities with classical, incomplete or most severe forms of the Kawasaki disease. The frequent troponin elevation and left ventricular dysfunction suggested the presence of acute myocarditis, although description of cardiac magnetic resonance imaging (MRI) is lacking. This case series describes the clinical presentation, characteristics, and management of the patients aged over 16 with coronavirus disease 2019 (COVID-19) admitted for suspected acute or fulminant myocarditis (according to the European Society of Cardiology and the American Heart Association definitions), including multisystem inflammatory syndrome, in the adult intensive and acute cardiac care units of a tertiary French center.

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