Histopathology of Cardiac Injury in COVID-19

Microthrombi enriched with fibrin and terminal complement C5b-9 were the most common reason for cardiac muscle necrosis in patients who died of COVID-19.

Critical COVID-19 illness is often marked by cardiac injury. Researchers have found that cardiac injury in COVID-19 is either part of global multi-organ dysfunction generally seen in critical illness or a less common vascular inflammatory syndrome (NEJM JW Infect Dis Feb 2020 and Circulation 2020 Nov 13; e-pub). These clinical features have lacked extensive histopathological studies. Now, investigators have detailed the results from autopsies of 40 hearts from hospitalized patients who died from severe COVID-19 in Bergamo, Italy (mean age, 74; 73% men).

Fourteen hearts (35%) showed evidence of cardiac myocyte necrosis. Chronic kidney disease was more frequent in cases with myocyte necrosis than in the 26 cases without necrosis — 36% vs. 8%. …

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases