Статья

[Miocarditis in Patients with COVID-19 Confirmed by Immunohistochemical].

E. Kogan, Y. Berezovskiy, O. Blagova, A. Kukleva, G. Bogacheva, E. Kurilina, D. Kalinin, T. Bagdasaryan, L. Semeyonova, E. Gretsov, A. Ergeshov, V. Fomin,
2020

Aim      Despite the regular heart damage in patients with coronavirus pneumonia caused by SARS-Cov-2, a possibility of developing lymphocytic myocarditis as a part of COVID-19 remains unsubstantiated. The aim of this study was to demonstrate a possibility of lymphocytic myocarditis and to study its morphological features in patients with the novel coronavirus infection (COVID-19) with a severe course.Material and methods   Postmortem data were studied for 5 elderly patients (74.8±4.4 years; 3 men and 2 women) with the novel coronavirus infection and bilateral, severe polysegmental pneumonia (stage 3-4 by computed tomography). COVID-19 was diagnosed based on the typical clinical presentation and positive polymerase chain reaction test in nasopharyngeal swabs. All patients were treated in different hospitals repurposed for the treatment of patients with COVID-19. A standard histological study was performed with hematoxylin and eosin, toluidine blue, and van Gieson staining. Serial paraffin slices were studied immunohistochemically with antibodies to CD3, СD68, CD20, perforin, and toll-like receptors (TLR) 4 and 9.Results In none of the cases, myocarditis was suspected clinically, added to the diagnosis or indicated as a possible cause of death. IHD and acute myocardial infarction were mentioned as error diagnoses not confirmed by the postmortem examination. The morphological examination of the heart identified signs of lymphocytic myocarditis consistent with Dallas criteria for this diagnosis. Myocardial infiltrate was characterized in detail, and a combined inflammatory damage of endocardium and pericardium was described. The immunohistochemical study with cell infiltrate typing confirmed the presence of CD3-positive Т lymphocytes and the increased expression of TLR-4. A picture of coronaritis, including that with microvascular thrombosis, was found in all cases.Conclusion      A possibility for development of lymphocytic viral myocarditis in COVID-19 was confirmed morphologically and immunohistochemically. Specific features of myocarditis in COVID-19 include the presence of coronaritis and a possible combination of myocarditis with lymphocytic endo- and pericarditis.

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  • 1. Version of Record от 2020-06-19

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Об авторах
  • E. Kogan
    Sechenov Fist Moscow State Medical University (Sechenov University), Moscow, Russia
  • Y. Berezovskiy
    Central Tuberculosis Research Institute, Moscow, Russia
  • O. Blagova
    Sechenov Fist Moscow State Medical University (Sechenov University), Moscow, Russia
  • A. Kukleva
    Sechenov Fist Moscow State Medical University (Sechenov University), Moscow, Russia
  • G. Bogacheva
    Sechenov Fist Moscow State Medical University (Sechenov University), Moscow, Russia
  • E. Kurilina
    National Medical Research Central for Cardiology, Moscow, Russia
  • D. Kalinin
    A.V.Vishnevsky Institute of Surgery, Moscow, Russia
  • T. Bagdasaryan
    Central Tuberculosis Research Institute, Moscow, Russia
  • L. Semeyonova
    Central Tuberculosis Research Institute, Moscow, Russia
  • E. Gretsov
    Central Tuberculosis Research Institute, Moscow, Russia
  • A. Ergeshov
    Central Tuberculosis Research Institute, Moscow, Russia
  • V. Fomin
    Sechenov Fist Moscow State Medical University (Sechenov University), Moscow, Russia
Название журнала
  • Kardiologiia
Том
  • 60
Выпуск
  • 7
Страницы
  • 4-10
Издатель
  • APO Society of Specialists in Heart Failure
Тип документа
  • journal article
Тип лицензии Creative Commons
  • CC BY
Правовой статус документа
  • Свободная лицензия
Источник
  • dimensions