ArticleClinical cardiology2022
Chronic biopsy proven post-COVID myoendocarditis with SARS-Cov-2 persistence and high level of antiheart antibodies.
Article in Clinical cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 37 citations in OpenAlex.
- Research progress on the association between viruses and cardiac diseases.Journal of virology · 2026Review
- Long-term cardiovascular impact of COVID-19 among hospitalised and non-hospitalised populations: a narrative synthesis review.Frontiers in cardiovascular medicine · 2026Review
- Do Long COVID and COVID Vaccine Side Effects Share Pathophysiological Picture and Biochemical Pathways?International journal of molecular sciences · 2025Review
- Cardio-Pulmonary Features of Long COVID: From Molecular and Histopathological Characteristics to Clinical Implications.International journal of molecular sciences · 2025Review
- The development of a therapeutic strategy for post-acute sequelae of COVID-19 should be based on an efficient classification of pathogenesis.Frontiers in medicine · 2025Article
- Risk impact of SARS-CoV-2 coronavirus and spike protein on cardiac tissue: a comprehensive review.Physiological research · 2024Review
- Post-Acute Sequelae of Covid-19: A System-wise Approach on the Effects of Long-Covid-19.American journal of medicine open · 2024Review
- Myocardial involvement in post-COVID-19 condition: a note from the surgical approach.Cardiovascular diagnosis and therapy · 2024Article
- Multimodal Assessment of Immunosuppressive Therapy in a Patient With Chronic Active Myocarditis 3 Months Following COVID-19 Infection.CJC open · 2024Article
- Mechanisms of long COVID: An updated review.Chinese medical journal pulmonary and critical care medicine · 2023Review
- The knowns and unknowns of cardiac autoimmunity in viral myocarditis.Reviews in medical virology · 2023Review
- Advancing Precision Medicine in Myocarditis: Current Status and Future Perspectives in Endomyocardial Biopsy-Based Diagnostics and Therapeutic Approaches.Journal of clinical medicine · 2023Review
- Hypertrophic Cardiomyopathy Complicated by Post-COVID-19 Myopericarditis in Patient withGenes · 2023Article
- Beyond Acute COVID-19: A Review of Long-term Cardiovascular Outcomes.The Canadian journal of cardiology · 2023Review
- SARS-CoV-2, vaccination or autoimmunity as causes of cardiac inflammation. Which form prevails?Herz · 2023Review
- Post-COVID myocarditis with antiheart antibodies persistence: Clues for autoimmunity?Clinical cardiology · 2023Article
- Corticosteroids are effective in the treatment of viruspositive post-COVID myoendocarditis with high autoimmune activity.Clinical cardiology · 2023Article
- Before blaming SARS-CoV-2 infection or vaccination for acute peripheral artery occlusion, rule out differential causes.Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia · 2023Article
- Chronic biopsy proven post-COVID myoendocarditis with SARS-Cov-2 persistence and high level of antiheart antibodies.Clinical cardiology · 2022Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo study the clinical signs and mechanisms (viral and autoimmune) of myoendocarditis in the long-term period after COronaVIrus Disease 2019 (COVID-19).
methodsFourteen patients (nine male, 50.1 ± 10.2 y.o.) with biopsy proven post-COVID myocarditis were observed. The diagnosis of COVID-19 was confirmed by IgG seroconversion. The average time of admission after COVID-19 was 5.5 [2; 10] months. An endomyocardial biopsy (EMB) of the right ventricle was obtained. The biopsy analysis included polymerase chain reaction diagnosis of viral infection, morphological, immunohistochemical (IHC) examination with antibodies to CD3, CD45, CD68, CD20, SARS-Cov-2 spike, and nucleocapsid antigens. Coronary atherosclerosis was ruled out in all patients over 40 years.
resultsThe new cardiac symptoms (congestive heart failure 3-4 New York Heart Association class with severe right ventricular involvement, various rhythm, and conduction disturbances) appeared 1-5 months following COVID-19. Magnetic resonance imaging showed disseminated or focal subepicardial and intramyocardial late gadolinium enhancement, hyperemia, edema, and increased myocardial native T1 relaxation time. Antiheart antibodies levels were increased 3-4 times in 92.9% of patients. The mean left ventricular (LV) ejection fraction (EF) was 28% (24.5; 37.8). Active lymphocytic myocarditis was diagnosed in 12 patients, eosinophilic myocarditis in two patients. SARS-Cov-2 RNA was detected in 12 cases (85.7%), in association with parvovirus B19 DNA-in one. Three patients had also endocarditis (infective and nonbacterial, with parietal thrombosis). As a result of steroid and chronic heart failure therapy, the EF increased to 47% (37.5; 52.5).
conclusionsCOVID-19 can lead to long-term severe post-COVID myoendocarditis, that is characterized by prolonged persistence of coronavirus in cardiomyocytes, endothelium, and macrophages (up to 18 months) in combination with high immune activity. Corticosteroids and anticoagulants should be considered as a treatment option of post-COVID myoendocarditis.
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