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      Myopericarditis as a Delayed Complication of COVID-19 Infection: A Case Report

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      Author(s): 1 , , 2 , 2 , 3
      Editor(s): ,
      Publication date (Electronic, pub):
      Publication date (Electronic, collection):
      Journal: Cureus
      Publisher: Cureus
      Keywords: viral pericarditis, cardiac arrythmia, cardiomyopathy, covid-19, myopericarditis, chest pain

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          Abstract

          Pericarditis is the inflammation of the pericardial layers. Myopericarditis is diagnosed when this inflammation involves the myocardium, which is marked by elevated serum cardiac enzymes. With these two pathologies sharing overlaps in etiology, we present a case of a young patient with a recent history of COVID-19 infection who presented with pleuritic and positional chest pain with troponin I elevation and serial ECG changes attributed to myopericarditis as a post-viral sequela of severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) infection. This case demonstrates the importance of identifying and managing the potential cardiac complications in coronavirus disease 2019 (COVID-19) patients, regardless of age or symptom onset.

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          COVID-19 and the Heart

          Akbarshakh Akhmerov, Eduardo Marbán (2020)
          Infection with the novel coronavirus, severe acute respiratory syndrome novel coronavirus, produces a clinical syndrome known as 2019 novel coronavirus disease. When severe, 2019 novel coronavirus disease is a systemic illness characterized by hyperinflammation, cytokine storm, and elevations of cardiac injury biomarkers. Here, we review what is known about the pathophysiology of 2019 novel coronavirus disease, its cardiovascular manifestations, and emerging therapeutic prospects. In this rapidly moving field, this review was comprehensive as of April 3, 2020.
          Article 0 comments Cited 364 times – based on 0 reviews     Review now
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            Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection

            Martina Patone, Xue Mei, Lahiru Handunnetthi … (2021)
            Although myocarditis and pericarditis were not observed as adverse events in coronavirus disease 2019 (COVID-19) vaccine trials, there have been numerous reports of suspected cases following vaccination in the general population. We undertook a self-controlled case series study of people aged 16 or older vaccinated for COVID-19 in England between 1 December 2020 and 24 August 2021 to investigate hospital admission or death from myocarditis, pericarditis and cardiac arrhythmias in the 1–28 days following adenovirus (ChAdOx1, n = 20,615,911) or messenger RNA-based (BNT162b2, n = 16,993,389; mRNA-1273, n = 1,006,191) vaccines or a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive test (n = 3,028,867). We found increased risks of myocarditis associated with the first dose of ChAdOx1 and BNT162b2 vaccines and the first and second doses of the mRNA-1273 vaccine over the 1–28 days postvaccination period, and after a SARS-CoV-2 positive test. We estimated an extra two (95% confidence interval (CI) 0, 3), one (95% CI 0, 2) and six (95% CI 2, 8) myocarditis events per 1 million people vaccinated with ChAdOx1, BNT162b2 and mRNA-1273, respectively, in the 28 days following a first dose and an extra ten (95% CI 7, 11) myocarditis events per 1 million vaccinated in the 28 days after a second dose of mRNA-1273. This compares with an extra 40 (95% CI 38, 41) myocarditis events per 1 million patients in the 28 days following a SARS-CoV-2 positive test. We also observed increased risks of pericarditis and cardiac arrhythmias following a positive SARS-CoV-2 test. Similar associations were not observed with any of the COVID-19 vaccines, apart from an increased risk of arrhythmia following a second dose of mRNA-1273. Subgroup analyses by age showed the increased risk of myocarditis associated with the two mRNA vaccines was present only in those younger than 40.
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              Evaluation and Treatment of Pericarditis: A Systematic Review.

              Massimo Imazio, Fiorenzo Gaita, Martin M. LeWinter (2015)
              Pericarditis is the most common form of pericardial disease and a relatively common cause of chest pain.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Cureus
                Journal ID (iso-abbrev): Cureus
                Journal ID (issn): 2168-8184
                Title: Cureus
                Publisher: Cureus (Palo Alto (CA) )
                ISSN (Electronic): 2168-8184
                Publication date (Electronic, pub): 7 October 2023
                Publication date (Electronic, collection): October 2023
                Volume: 15
                Issue: 10
                Electronic Location Identifier: e46655
                Affiliations
                [1 ] Medical School, Kirk Kerkorian School of Medicine at the UNLV (University of Nevada, Las Vegas), Las Vegas, USA
                [2 ] Internal Medicine, Kirk Kerkorian School of Medicine at the UNLV (University of Nevada, Las Vegas), Las Vegas, USA
                [3 ] Cardiology, Kirk Kerkorian School of Medicine at the UNLV (University of Nevada, Las Vegas), Las Vegas, USA
                Author notes
                Article
                DOI: 10.7759/cureus.46655
                PMC ID: 10627796
                SO-VID: 57e90eea-3757-46c1-b8c1-9b9bbd7bc492
                Copyright © Copyright © 2023, Moreno et al.
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date accepted : 7 October 2023
                Categories
                Subject: Internal Medicine
                Subject: Cardiology
                Subject: Infectious Disease

                Keywords: viral pericarditis,cardiac arrythmia,cardiomyopathy,covid-19,myopericarditis,chest pain
                Data availability:
                Keywords: viral pericarditis, cardiac arrythmia, cardiomyopathy, covid-19, myopericarditis, chest pain

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