Abstract
Abstract Aims There are many possible causes of myocardial injury in long COVID patients. The aim of the study was to search by endomyocardial biopsy EMB in patients with not previous comorbidities histopathological causes. Material and Methods This is part of a single center registry, 209 patients with chest pain due to long COVID without previous known comorbidities, all patients have had positive COVID polymerase chain reaction (PCR) or rapid antigen test. The median of 32.56 weeks following diagnosis, due to lack of improvement of symptoms with medical treatment, according with clinical, laboratory results, echocardiography, and cardiac magnetic resonance (CMR), the endomyocardial biopsy (EMB) was performed, a total of 16 patients from January 2021 to January 2024 were included. Results Of the 16 patients included,7 (43%) had persistent high-sensitive I troponin (HS-TnT) and 8 (50%) HS-CRP, all patients have low vitamin D level. 5 of them 31% evidenced myocardial injury in CMR, elevated T1 or T2 mappings, anormal extracellular Volume (ECV), or late gadolinium enhancement (LGE). The main findings in histopathology, immunohistochemistry staining, and PCR proof of viral genome. 12 (75%) patients had had diffuse ischemic necrosis with loss of general myocardial architecture, and interstitial edema, early cellular degeneration in the presence of intracytoplasmic lipofuscin 2 patients have lymphocytic myocarditis criteria, from this 2, 1 had immunoperoxidase for SARS-Cov2 (Bio&Sb), where nuclei with uptake evidenced with diaminobenzidine favors virus infection (Sars-Cov2), 1 patient thrombotic microangiopathy and 1 AA amyloidosis. Conclusion Most of patients have diffuse ischemic necrosis instead, inflammatory changes, also it is possible to find AA amyloidosis and thrombotic microangiopathy table 1 and 2
Published Version
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