Treatment of myocarditis in COVID-19 patients

Abstract

Objective. To describe a few cases of COVID-19-associated myocardial damage, to analyze its pathogenesis, approaches to diagnosis and treatment. Material and methods. All our patients with myocarditis and a new coronavirus infection had life-threatening heart rhythm disturbances, including ventricular fibrillation with clinical death and subsequent intensive care, syncope following bradyarrhythmia in 2 cases, as well as atrial fibrillation with thrombosis of the right atrial appendage. Results. In all cases, specialized medical care saved patient lives, and appropriate therapy restored sinus rhythm and compensated heart failure. Heart rhythm disturbances in our patients were transient and regressed within 3 months. Specific drug therapy was carried out according to generally accepted approaches, and only 1 patient with sudden ventricular fibrillation and subsequent successful intensive care required implantable cardioverter-defibrillator. Conclusion. Myocarditis following a new coronavirus infection may be accompanied by life-threatening heart rhythm disturbances with possible fatal outcomes in the absence of appropriate medical care. The features of myocarditis associated with SARS-CoV-2 infection may be a delayed nature of clinical manifestations or lightning-fast course with acute heart failure, arrhythmias, as well as transient damage with fast recovery throughout the treatment. Follow-up of patients with previous inflammatory myocardial lesions, analysis of other cases of COVID-19-associated myocarditis and a large sample are necessary for subsequent analysis. © 2022, Media Sphera Publishing Group. All rights reserved.