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Coronavirus Disease 2019 Acute Myocarditis and Multisystem Inflammatory Syndrome in Adult Intensive and Cardiac Care Units

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Chest 2021 Feb;159(2):657-662
Article disponible en consultant le site


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.



Hyperinflammatory shock was described recently 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 classic, 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 MRI is lacking.


This case series describes the clinical presentation, characteristics, and management of the patients over 16 years old with coronavirus disease 2019 (COVID-19) who were admitted for suspected acute or fulminant myocarditis (according to the European Society of Cardiology and the American Heart Association definitions) and included multisystem inflammatory syndrome in the adult intensive and acute cardiac care units of a tertiary French center.


From February 25 to June 25, 2020, 20 patients were admitted in our institution for clinically suspected acute or fulminant myocarditis (viral, 16 patients; autoimmune, three patients; and toxic, one patient). Eleven patients had a confirmed SARS-CoV-2 infection based on positive reverse transcriptase-polymerase chain reaction (RT-PCR) or serology. Our study reports these 11 cases. In accordance with the ethical standards of our hospital’s institutional review board and French law, all patients or close relatives were informed that their personal data were collected in this case series and that they could decline inclusion. The National Commission for Informatics and Liberties approved this study (no.1950673).



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