Reports of sudden cardiac deaths linked to COVID-19 have been circulating since the early days of the pandemic. The reason has long been described as myocarditis, an inflammation of the heart muscle that can result from viral infections. However, a number of autopsies performed on victims of the respiratory disease have revealed that the novel coronavirus isn’t causing the typical, expected form of myocarditis and is instead triggering an unusual pattern of heart cell death.
Myocarditis is an inflammation caused by a viral infection that can result in abnormal heart rates and reduced pumping ability; in the worst scenario, the patient may experience heart failure that could be fatal. Cardiac deaths experienced by COVID-19 victims were assumed to be the result of myocarditis, but a new study from Louisiana State University Health Sciences Center says something else may be going on.
The Circulation research letter describes the findings of autopsies performed on people who died from COVID-19, reporting that ‘scattered individual’ cells in the heart muscle experienced ‘a unique pattern of cell death’ that led to the cardiac disturbance. This differs from the expected inflammation that marks myocarditis, something the researchers describe as ‘surprising.’
The SARS-CoV-2 virus responsible for COVID-19 wasn’t found in the heart muscle cells of patients, but they did have ‘severely enlarged right ventricles.’ The reasons for this unusual finding isn’t yet known, but may be due to extreme stress on the heart caused by the new SARS disease, as well as the immune response known as a cytokine storm and possibly inflammation of the endothelium (lining) of small blood vessels.
LSU Health New Orleans School of Medicine Director of Pathology Research Richard Vander Heide, MD, Ph.D., explained:
We identified key gross and microscopic changes that challenge the notion that typical myocarditis is present in severe SARS-CoV-2 infection. While the mechanism of cardiac injury in COVID-19 is unknown, we propose several theories that bear further investigation that will lead to greater understanding and potential treatment interventions.