Fetal Pediatr Pathol. 2020 May 13:1-6. doi: 10.1080/15513815.2020.1761491. [Epub ahead of print]
Fatal Eosinophilic Myocarditis in a Healthy 17-Year-Old Male with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2c).
Craver R1,2, Huber S2,3, Sandomirsky M3, McKenna D3, Schieffelin J4,5, Finger L6,7.
Author information
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.
Am J Physiol Lung Cell Mol Physiol. 2020 May 13. doi: 10.1152/ajplung.00144.2020. [Epub ahead of print]
Treatment of COVID-19 exacerbated asthma: should systemic corticosteroids be used?
Kumar K1, Hinks TS2, Singanayagam A1.
Abstract
Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 infection is a new rapidly spreading infectious disease. Current guidance from the World Health Organisation (WHO) highlights asthmatics as a high-risk group for severe illness from COVID-19. Viruses are common triggers of asthma exacerbations and the current SARS-CoV-2 pandemic raises several questions regarding the optimum management strategies. Here, we discuss the contentious issue of whether the mainstay therapies systemic corticosteroids should be used in the routine management of COVID-19-associated asthma exacerbations. Recent guidance from the WHO has advised against the use of corticosteroids if COVID-19 is suspected due to concerns that these agents may impair protective innate anti-viral immune responses. This may not be appropriate in the unique case of asthma exacerbation, a syndrome associated with augmented type 2 inflammation, a disease feature that is known to directly inhibit anti-viral immunity. Corticosteroids, through their suppressive effects on type 2 inflammation, are thus likely to restore impaired anti-viral immunity in asthma and, in contrast to non-asthmatic subjects, have beneficial clinical effects in the context of SARS-CoV-2 infection
https://doi.org/10.1152/ajplung.00144.2020