Evidence map›Paper›PMID 37853435›Full record

ArticleDiagnostic pathology2023

Evidence of autoinflammation as a principal mechanism of myocardial injury in SARS-CoV-2 PCR-positive medical examiner cases.

Margo E Hammond, Erik D Christensen, Michael Belenky, Gregory L Snow, Kevin Shah, M Elizabeth H Hammond

Abstract read
In one paragraph

Article in Diagnostic pathology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
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  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Margo E HammondDepartment of Chemistry and Biochemistry, Brigham Young University, Provo, UT, USA.
Erik D ChristensenOffice of the Medical Examiner, Utah Department of Health and Human Services, Salt Lake City, Utah, USA.
Michael BelenkyOffice of the Medical Examiner, Utah Department of Health and Human Services, Salt Lake City, Utah, USA.
Gregory L SnowOffice of Research, Intermountain Medical Center, Salt Lake City, Utah, USA.
Kevin ShahCardiology Division, University of Utah School of Medicine, Salt Lake City, Utah, USA.
M Elizabeth H HammondCardiology Division, University of Utah School of Medicine, Salt Lake City, Utah, USA. Liz.hammond@hotmail.com.ORCID http://orcid.org/0000-0001-9676-3261

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDisease from Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) remains the seventh leading cause of death in the United States. Many patients infected with this virus develop later cardiovascular complications including myocardial infarctions, stroke, arrhythmia, heart failure, and sudden cardiac death (20-28%). The purpose of this study is to understand the primary mechanism of myocardial injury in patients infected with SARS-CoV-2.

methodsWe investigated a consecutive cohort of 48 medical examiner cases who died with PCR-positive SARS-CoV-2 (COVpos) infection in 2020. We compared them to a consecutive cohort of 46 age- and sex-matched controls who were PCR-negative for SARS-CoV-2 (COVneg). Clinical information available at postmortem examination was reviewed on each patient. Formalin-fixed sections were examined using antibodies directed against CD42 (platelets), CD15 (myeloid cells), CD68 (monocytes), C4d, fibrin, CD34 (stem cell antigen), CD56 (natural killer cells), and myeloperoxidase (MPO) (neutrophils and neutrophil extracellular traps(NETs)). We used a Welch 2-sample T-test to determine significance. A cluster analysis of marker distribution was also done.

resultsWe found a significant difference between COVpos and COVneg samples for CD42, CD15, CD68, C4d, fibrin, and MPO, all of which were significant at p < 0.001. The most prominent features were neutrophils (CD15, MPO) and MPO-positive debris suggestive of NETs. A similar distribution of platelets, monocytes, fibrin and C4d was seen in COVpos cases. Clinical features were similar in COVpos and COVneg cases for age, sex, and body mass index (BMI).

conclusionThese findings suggest an autoinflammatory process is likely involved in cardiac damage during SARS-CoV-2 infection. No information about clinical cardiac disease was available.

Indexed as

COVID-19Coroners and Medical ExaminersCOVID-19 TestingFibrinHumansPolymerase Chain ReactionSARS-CoV-2FibrinAutoinflammationCoagulopathyComplementHeartMyocarditisNeutrophilsSARS-COV-2

Identifiers

PMID37853435
PMCPMC10585907

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.