Myocardial Localization of Coronavirus in COVID-19 Cardiogenic Shock
Guido Tavazzi, Carlo Pellegrini, M. Maurelli, Mirko Belliato, Fabio Sciutti, Andrea Bottazzi, Paola Alessandra Sepe, Tullia Resasco, Rita Camporotondo, Raffaele Bruno, Fausto Baldanti, Stefania Paolucci, Stefano Pelenghi, Giorgio Antonio Iotti, Francesco Mojoli, Eloisa Arbustini
Abstract
We describe the first case of acute cardiac injury directly linked to myocardial localization of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a 69-year-old patient with flu-like symptoms rapidly degenerating into respiratory distress, hypotension, and cardiogenic shock. The patient was successfully treated with venous-arterial extracorporeal membrane oxygenation (ECMO) and mechanical ventilation. Cardiac function fully recovered in 5 days and ECMO was removed. Endomyocardial biopsy demonstrated low-grade myocardial inflammation and viral particles in the myocardium suggesting either a viraemic phase or, alternatively, infected macrophage migration from the lung.