Late Cardiac Pathology in Severe Covid-19. A Postmortem Series of 30 Patients

Frontiers in Cardiovascular Medicine

José Palacios¹  Belén Pérez-Mies¹  David Pestaña²  José Luis Zamorano⁴  Juan Carlos Galán⁵  Antonia Navarro-Cantero⁶  Ana Ferrer-Gómez⁶  Irene Carretero-Barrio⁶  Ignacio Ruz-Caracuel⁷  Raúl de Pablo⁸  Héctor Pian-Arias^1,10 

[1] 0Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain;Anaesthesiology and Surgical Critical Care Department, Hospital Universitario Ramón y Cajal, Madrid, Spain;Cardiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain;Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain;Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain;Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain;Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain;Medical Intensive Care Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain;Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain;Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain;

关键词: COVID-19;    SARS-CoV-2;    heart;    cardiac pathology;    autopsy;   

DOI  :  10.3389/fcvm.2021.748396

来源: DOAJ

【 摘 要 】

The role of SARS-CoV-2 as a direct cause in the cardiac lesions in patients with severe COVID-19 remains to be established. Our objective is to report the pathological findings in cardiac samples of 30 patients who died after a prolonged hospital stay due to Sars-Cov-2 infection. We performed macroscopic, histological and immunohistochemical analysis of the hearts of 30 patients; and detected Sars-Cov-2 RNA by RT-PCR in the cardiac tissue samples. The median age of our cohort was 69.5 years and 76.6% were male. The median time between symptoms onset and death was 36.5 days. The main comorbidities were arterial hypertension (13 patients, 43.3%), dyslipidemia (11 patients, 36.7%), cardiovascular conditions (8 patients, 26.7%), and obesity (8 patients, 26.7%). Cardiovascular conditions included ischemic cardiopathy in 4 patients (13.3%), hypertrophic cardiomyopathy in 2 patients (6.7%) and valve replacement and chronic heart failure in one patient each (3.3%). At autopsy, the most frequent histopathological findings were coronary artery atherosclerosis (8 patients, 26.7%), left ventricular hypertrophy (4 patients, 13.3%), chronic epicardial inflammation (3 patients, 10%) and adipose metaplasia (2 patients, 6.7%). Two patients showed focal myocarditis, one due to invasive aspergillosis. One additional patient showed senile amyloidosis. Sars-Cov-2 RNA was detected in the heart of only one out of 30 patients, who had the shortest disease evolution of the series (9 days). However, no relevant cardiac histological alterations were identified. In present series, cardiac pathology was only modest in most patients with severe COVID-19. At present, the contribution of a direct effect of SARS-CoV-2 on cardiac lesions remains to be established.

【 授权许可】

Unknown