Imaging in COVID-19-related myocardial injury
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REVIEW PAPER
Imaging in COVID‑19‑related myocardial injury Riccardo Cau1 · Pier Paolo Bassareo2 · Lorenzo Mannelli3 · Jasjit S. Suri4 · Luca Saba1 Received: 11 June 2020 / Accepted: 26 October 2020 © The Author(s) 2020
Abstract Severe acute respiratory syndrome coronavirus 2 (SARS- CoV-2), previously named “2019 novel coronavirus” (2019-nCoV) is an emerging disease and a major public health issue. At the moment, little is known, except that its spread is on a steady upward trend. That is the reason why it was declared pandemic since March 11th, 2020. Respiratory symptoms dominate the clinical manifestations of the virus, but in a few patients also other organs are involved, such as their heart. This review article provides an overview of the existing literature regarding imaging of heart injury during COVID-19 acute infection and follow-up. Keywords COVID-19 · Imaging · CMR · Myocarditis · Heart injury Abbreviations SARS- CoV-2 Severe acute respiratory syndrome coronavirus 2 2019-nCoV 2019 Novel coronavirus SARS Severe acute respiratory syndrome MERS-CoV Middle East respiratory syndrome CK Creatine kinase CKMB Creatine kinase-MB cTnI Cardiac troponin I HBDB α-Hydroxybutyrate dehydrogenase LDH Lactate dehydrogenase EBM Endomyocardial biopsy ESC European Society of Cardiology CMR Cardiac magnetic resonance NT-proBNP N-terminal pro B-type natriuretic peptide IL-6 Interleukin 6 FM Fulminant myocarditis * Luca Saba [email protected] 1
Department of Radiology, Azienda Ospedaliero Universitaria (A.O.U.), di Cagliari – Polo di Monserrato s.s. 554 Monserrato, 09045 Cagliari, Italy
2
Mater Misericordiae University Hospital and Our Lady’s Children’s Hospital, University College of Dublin, Crumlin, Dublin, Republic of Ireland
3
IRCSS SDN, Naples, Italy
4
Stroke Monitoring and Diagnostic Division, ATHEROPOINT LLC, Roseville, CA, USA
99mTc-MIBI SPECT Technetium-99m-labelled methoxyisobutyl isonitrile SPECT CCT Cardiac computed tomography LGE Late gadolinium enhancement
Background In December 2019, different pneumonia cases of unknown aetiology presenting with severe acute respiratory syndrome (SARS), occurred in Wuhan, Hubei Province, China [1, 2]. Since then, the disease has been spreading quickly from Wuhan to other geographical areas and countries. As to September 22th, 2020, 2,923,580 COVID cases in Europe were confirmed [3]. The SARS- CoV-2 has features which are typical of the coronavirus family. SARSCoV-2 shares 82% genome sequence similarity to SARSCoV and 50% genome sequence homology to Middle East respiratory syndrome coronavirus (MERS-CoV) [4]. Coronaviruses are quite common human pathogens, causing from mild acute respiratory disease (the common cold) to severe and potentially lethal respiratory tract infections [5]. A large number of reports provide descriptions of the clinical signs associated with COVID-19. Sun et al. observed that the most represented symptoms are fever and cough [6]. It is well known that different types of viruses, such as adenovirus, enterovirus and h
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