Fatal Eosinophilic Myocarditis in a Healthy 17-Year-Old Male with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2c)

Fetal Pediatr Pathol. 2020 Jun;39(3):263-268. doi: 10.1080/15513815.2020.1761491. Epub 2020 May 13.

Abstract

Background: Cardiac damage is frequently referred to in patients with SARS-CoV-2, is usually diagnosed by enzyme elevations, and is generally thought to be due to underlying coronary artery disease. There are references to cardiomyopathies accompanying coronavirus, but there has been no histologic confirmation.Case report: A previously healthy 17 year male old presented in full cardiac arrest to the emergency department after a 2 day history of headache, dizziness, nausea and vomiting. Autopsy demonstrated an enlarged flabby heart with eosinophilic myocarditis. There was no interstitial pneumonia or diffuse alveolar damage. Postmortem nasopharyngeal swabs detected severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) known to cause coronavirus disease 2019 (COVID-19). No other cause for the eosinophilic myocarditis was elucidated.Conclusion: Like other viruses, SARS-CoV-2 may be associated with fulminant myocarditis.

Keywords: COVID 19; SARS-CoV-2; coronavirus disease 2019; eosinophilic myocarditis; severe respiratory syndrome coronavirus 2.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Betacoronavirus
  • COVID-19
  • Coronavirus Infections / complications
  • Coronavirus Infections / mortality*
  • Eosinophilia / complications
  • Eosinophilia / mortality*
  • Fatal Outcome
  • Heart Arrest / complications
  • Heart Arrest / virology
  • Humans
  • Male
  • Myocarditis / complications
  • Myocarditis / mortality*
  • Myocarditis / virology*
  • Pandemics
  • Pneumonia, Viral / complications
  • Pneumonia, Viral / mortality*
  • SARS-CoV-2