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. 2020 May 28;2(4):278–285. doi: 10.1016/j.cjco.2020.05.005

Table 1.

Published literature highlighting clinically suspected myocarditis in COVID-19 patients

Study Case Clinical Troponin NT-proBNP ECG TTE CMR EMB Outcome
Inciardi et al.7 53 M Cough
Fatigue
Fever
Troponin T: 0.24 ng/mL 5647 pg/mL Minimal diffuse ST segment elevation (more prominent in inferolateral leads) and ST depression with T wave inversion in lead V1 and aVR LVEF 40% Short tau inversion recovery and T2 mapping sequences showing biventricular myocardial interstitial edema. Inversion recovery sequences showing biventricular wall diffuse LGE N/A Clinical improvement
Zeng et al.5 63 M Chest pain
Cough
Dyspnea
Fever
Sputum
Troponin I: 11.37 g/L 22,600 pg/mL Sinus tachycardia, no ST elevation LVEF 32% N/A N/A ECMO as a bridge to clinical recovery
Hu et al.8 37 M Chest pain
Diarrhea
Dyspnea
Troponin T: > 10,000 ng/L 21,025 ng/L ST segment elevation in lead 3, aVF LVEF 27% N/A N/A Clinical recovery
Tavazzi et al.18 69 M Cough
Dyspnea
Weakness
Troponin I: 4331 ng/L N/A N/A LVEF 34% N/A CD68+ macrophages with viral particles noted. No virus in cardiac myocytes Death from bacterial sepsis
Sala et al.36 43 F Chest pain
Dyspnea
Troponin T: 135 ng/L 512 pg/mL Atrial ectopic rhythm, mild ST segment elevation in V1, V2, aVR; reciprocal ST depression in V4-V6 LVEF 43% Basal and mid-LV hypokinesis with diffuse myocardial edema. LGE showed absence of scar and necrosis Diffuse T-lymphocytic inflammatory infiltrates with interstitial edema and limited necrosis. No viral genome in myocardium Clinical recovery
Doyen et al.37 69 M Cough
Diarrhea
Dyspnea
Fever
Vomiting
Troponin I: 9002 ng/L N/A Criteria for left ventricular hypertrophy and diffuse inverted T waves LVEF > 50% Subepicardial LGE of the apex and inferolateral wall N/A Clinical recovery
Coyle et al.38 57 M Cough
Diarrhea
Dyspnea
Fever
Nausea
Troponin I: 7.33 ng/mL 1300 pg/mL Sinus tachycardia, no ST-T wave changes LVEF 35%-40% Diffuse biventricular and biatrial edema with a small area of LGE N/A Clinical recovery
Luetkens et al.39 79 M Dyspnea
Fatigue
Syncope
Troponin T: 63.5 ng/L 1178 pg/mL Normal LVEF > 50% Diffuse interstitial myocardial edema with an increased T2 signal intensity ratio. T2 mapping showed diffuse myocardial inflammation N/A Clinical recovery
Kim et al.40 21 F Cough
Diarrhea
Dyspnea
Fever
Sputum
Troponin I: 1.26 ng/mL 1929 pg/mL Nonspecific interventricular conduction delay and multiple premature ventricular complexes LVEF < 35% Diffuse high signal intensity in the LV myocardium on T2 short tau inversion recovery image, and myocardial wall edema. Extensive transmural LGE N/A N/A

CMR, cardiac magnetic resonance; ECG, electrocardiogram; ECMO, extracorporeal membrane oxygenator; F, female; EMB, endomyocardial biopsy; LGE, late gadolinium enhancement; LV, left ventricular; LVEF, left ventricular ejection fraction, M, male; N/A, not available; NT-proBNP, N terminal pro B type natriuretic peptide; TTE, transthoracic echocardiography.