Acute myocarditis related to Covid-19 infection: 2 cases report

• Published in: Annals of medicine and surgery Vol. 66; p. 102431
• Main Authors: Kallel, O., Bourouis, I., Bougrine, R., Housni, B., El Ouafi, N., Ismaili, N.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.06.2021; Elsevier
• Subjects: Acute myocarditis; Case Report; Coronavirus infections; COVID-19; Fulminant myocarditis; COVID-19; Acute myocarditis; Case report; Coronavirus infections; Fulminant myocarditis
• ISSN: 2049-0801; 2049-0801
• DOI: 10.1016/j.amsu.2021.102431

Since COVID 19 was described for the first time in December 2019, we have not stopped discovering its different clinical manifestations. Despite the respiratory complication which is the most common symptomatology, multi-organ dysfunction and multiple cardiovascular complications were described such as acute myocarditis, heart failure and even arrhythmias. Two patients aged 26 and 56 year-old, developed acute myocarditis related to Covid-19 infection but with different symptomatology. Presented to the emergency room with digestive symptomatology, Covid-19 infection was confirmed by a positive chest CT scan and positive COVID-19 serology testing. Clinical, biological, radiological findings allowed making the diagnosis of a Covid-19 infection with a bacterial superinfection complicated by a fulminant myocarditis. Presented to the emergency department with a chest pain, dyspnoea, paroxistic cough, myalgia and fever. A Covid-19 infection was confirmed. The electrocardiogram showed a diffuse ST elevation, echocardiography showed normal systolic function and the high-sensitivity cardiac troponin I level was high. Invasive coronary angiography was performed, revealing angiographically normal coronary arteries. Our 2 cases were treated differently, case 1 received antibiotherapy because of the bacterial superinfection and inotropic support for the septic and cardiogenic choc. Contrarily to case 2 who received inotropic support, immunoglobulin and corticosteroid. With a total recovery for both patients. This article can help in considering cardiac affection due to SARS-CoV2, even with poor respiratory symptomatology, and to insist on the importance of the cardiac evaluation for young patients with a sever Covid-19 infection. •COVID- 19 (coronavirus disease 2019), caused by the SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2), was described for the first time in Whuan, China in December 2019.•Respiratory symptoms present the most common clinical manifestation, but also multi-organ dysfunction and multiple cardiovascular complications was described such as acute myocarditis, heart failure and even arrhythmias.•We present in this article two patients aged 26 and 56 year-old, developed acute myocarditis related to Covid-19 infection but with different symptomatology.•Physicians should not neglect extra respiratory symptoms which can hide a COVID-19 complicated infection, and a cardiac evaluation is necessary even for young patients with a sever Covid-19 infection.