SARS-CoV-2 is localized in cardiomyocytes: a postmortem biopsy case

Yoshihiko Nakamura; Harutaka Katano; Noriko Nakajima; Yuko Sato; Tadaki Suzuki; Tsuyoshi Sekizuka; Makoto Kuroda; Yoshito Izutani; Shinichi Morimoto; Junichi Maruyama; Megumi Koie; Taisuke Kitamura; Hiroyasu Ishikura

doi:10.1016/j.ijid.2021.08.015

SARS-CoV-2 is localized in cardiomyocytes: a postmortem biopsy case

Int J Infect Dis. 2021 Oct:111:43-46. doi: 10.1016/j.ijid.2021.08.015. Epub 2021 Aug 9.

Authors

Affiliations

¹ Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan. Electronic address: pdmxy@yahoo.co.jp.
² Department of Pathology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan. Electronic address: katano@nih.go.jp.
³ Department of Pathology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan. Electronic address: tenko@nih.go.jp.
⁴ Department of Pathology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan. Electronic address: kiyonaga@nih.go.jp.
⁵ Department of Pathology, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan. Electronic address: tksuzuki@nih.go.jp.
⁶ Pathogen Genomics Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan. Electronic address: sekizuka@nih.go.jp.
⁷ Pathogen Genomics Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku, Tokyo 162-8640, Japan. Electronic address: makokuro@nih.go.jp.
⁸ Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan. Electronic address: nrk14110@yahoo.co.jp.
⁹ Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan. Electronic address: otomirom7960@yahoo.co.jp.
¹⁰ Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan. Electronic address: marujun1025@icloud.com.
¹¹ Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan. Electronic address: m_33_skyline@yahoo.co.jp.
¹² Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan. Electronic address: taisuke@kitamura.or.jp.
¹³ Department of Emergency and Critical Care Medicine, Fukuoka University Hospital, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan. Electronic address: ishikurah@fukuoka-u.ac.jp.

Abstract

A 72-year-old patient was admitted to the intensive care unit due to acute respiratory distress syndrome caused by COVID-19. On day 20, the patient experienced shock. The electrocardiogram showed ST segment elevation in leads V3-V6 and severe left ventricular dysfunction with an ejection fraction of 35%-40%. The left ventricle showed basal hypokinesis and apical akinesis, while the creatine kinase level was normal, indicating Takotsubo cardiomyopathy. On day 24, the patient died of multiple organ failure. In post-mortem biopsy, SARS-CoV-2 antigen was detected in cardiomyocytes by immunostaining. Moreover, SARS-CoV-2 RNA was detected in heart tissue. We need to further analyse the direct link between SARS-CoV-2 and cardiomyocytes.

Keywords: SARS-CoV-2; cardiomyocyte; co-localization; immunostaining.

Publication types

Case Reports

MeSH terms

Aged
Biopsy
COVID-19*
Humans
Myocytes, Cardiac
RNA, Viral
SARS-CoV-2
Takotsubo Cardiomyopathy*

Substances

RNA, Viral