covid -19相关心肌炎:大流行形势下的当前问题

S. P. Surya, R. M. Santoso
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摘要

简介:严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)因其易在人与人之间传播而成为世界性的医学问题。人血管紧张素转换酶-2 (hACE2)的表达通过其与SARS-CoV-2刺突蛋白的亲和力进入SARS-CoV-2。在患者感染了SARS-CoV-2之后,随后可能导致与COVID-19相关的心肌炎。然而,目前仍没有实用的指南,它显著影响了COVID-19患者的发病率和死亡率状况。在本病例报告中,我们展示了诊断和治疗COVID-19相关心肌炎的挑战。病例介绍:A-45岁男性,因新冠肺炎从科马约兰运动员村急诊医院转诊至我院,胸痛典型。他感到胸口有一种压碎的感觉,而且这种感觉每分钟都在加剧。心电图检查显示所有心前导联及下导联st段抬高。他的实验室工作显示炎症和心肌肌钙蛋白标志物显著增加。他的血管造影检查显示没有明显病变。不幸的是,由于大流行的限制,无法进行活检。我们诊断该患者为COVID-19相关心肌炎,治疗一周后出院。目前,COVID-19相关心肌炎的诊断和治疗尚无指南。结论:新冠肺炎疫情已成为医疗实践中的一个新问题。不仅是肺,它还涉及到许多其他器官,心脏是最常见的器官之一。COVID-19感染的心脏并发症之一是COVID-19相关性心肌炎。目前,新冠肺炎相关心肌炎的诊断和治疗尚无指南,我们鼓励国际社会予以关注。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
COVID-19-related Myocarditis: Current Issue in Pandemic Situation
Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a worldwide medical issue since it is easily transmitted from human to human. The human angiotensin-converting enzyme-2 (hACE2) expression gives access to SARS-CoV-2 through its affinity with the spike protein of SARS-CoV-2. Right after the patient has been infected with SARS-CoV-2, subsequently, it may lead to COVID-19 related myocarditis. However, there is still no practical guideline and it significantly affects morbidity and mortality status of COVID-19 patient. In this case report, we are showing challenges in diagnose and treat COVID-19 related myocarditis.  Case presentation: A-45 years old man was referred to our hospital from Emergency Hospital for COVID-19 Kemayoran Athletes Village with typical chest pain. He felt a crushing sensation in his chest and it was intensifying every minute. The ECG examination showed ST-segment elevation in all precordial lead and inferior lead. His laboratory work revealed a significant increase of inflammation and cardiac troponin marker. His angiography examination came up with non-significant lesion. Unfortunately, biopsy couldn’t be done due to pandemic limitation. We were diagnosing the patient with COVID-19 related myocarditis and one week after treatment he was discharged from hospital. Currently, there were no diagnostic and treatment guideline for COVID-19 related myocarditis. Conclusion: COVID-19 has become a novel glitch in medical practice situations. Not only lung, but it involves many other organs, and the heart is one of the most common organs involved. One of the cardiac complications of COVID-19 infection is COVID-19 related myocarditis. Currently, there is no guideline in diagnosing and treating COVID-19 related myocarditis and we are encouraging the international society to put an eye on it.
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