CLINICAL AND MORPHOLOGICAL CHARACTERISTICS OF COVID-19 ASSOCIATED MYOCARDITIS

Abstract

The article is devoted to the actual problem in the case of ongoing COVID-19 pandemic – the clinical and morphological characteristics of СOVID-19 associated myocarditis in conditions of non-widespread of this topic. The aim of the study is to study the clinical and morphological features of COVID-19 associated heart damage in deceased patients. The study included data from medical cards of inpatients of Almaty City cardiological center, as well as postmortem data of 12 patients (9 men and 3 women, average of age 65,6±13,8, 51–80 years), dead patients with a diagnosis of atherosclerosis-associated diseases. Pathological anatomical autopsy was performed at the Central Pathological Anatomical Department of Federal Health Institution “Central Medical and Sanitary Unit No. 1 of the Federal Medical and Biological Agency Hospital №1 Russia. Extrapolating data from the pathomorphological study of deceased patients, who had a history of coronavirus infection and died from circulatory system diseases, on autopsy it was found that SARS-Cov-2 infection led to the development of subacute/chronic myocarditis. Its clinical manifestations develop within 4-6 months or more than a year after acute COVID-19 in the form of myocardial infarction or progressive heart failure. The researchers also emphasize the extreme importance of performing autopsy studies of any nosology in combination with COVID-19, for subsequent clinical and morphological analysis, which provide invaluable opportunities to summarize each morphological manifestation of this infection to be further compared to clinical manifestations. Thus, at present, any unclear myocardial dysfunction requires serodiagnosis of a new coronavirus infection. SARS-Cov-2 infection can cause chronic nonbacterial lymphocytic thromboendocarditis with an autoimmune mechanism; as well as its combination with lymphocytic myocarditis. Research in this field still needs to be continued.