Saudi Journal for Health Sciences (Jan 2023)
Cardiac autopsy findings in patients with COVID-19: A review of the literature
Abstract
Coronavirus disease 2019 (COVID-19) infection was first discovered in December 2019 and was soon declared a worldwide pandemic. With the decrease in the severity of the deadly disease, there is a false sense of relief globally. However, there has been an increasing trend in the cases of cardiovascular and other complications of COVID-19 which has raised concern about the sequelae of this infection. The number of cases of sudden cardiac death and myocardial infection, post-COVID-19 has seen a major leap, especially in healthy people of both genders. Systemic comorbidities and immunocompromised states have a direct effect on the prognosis of patients. The SARS-CoV-2 infection not just affects the respiratory system but multi-organ involvement is seen due to this deadly virus. The heart is a vital organ that has acute- acute and long-term consequences, what is known as long-COVID, which lead to increased morbidity and mortality. There are increased cases of multiple cardiovascular problems such as blood clots, cardiovascular accidents, myocarditis, myocardial infarction, and heart failure in people after recovering from SARS-CoV-2 infection. The histopathological findings in the heart due to COVID-19 infection can be interstitial edema with the presence or absence of myocarditis, lymphocytic endotheliitis, microvascular microthrombi, thrombosis, interstitial fibrosis with no endothelins, or rarely myocarditis. While the tissue diagnosis during acute illness is less likely feasible, autopsy findings can be helpful to understand better pathophysiology of the disease and thus help in the better management of the patient. This review was performed to analyze the postmortem findings of the heart in patients infected with the SARS-COV-2 virus, to understand the effect of COVID-19 and its complications on the heart. The pathological changes in the cardiovascular system need to be explained and correlated with the clinical findings and prognosis of the patients. We also want to hypothesize that these findings, especially myocarditis lead to sudden death in the young, which gets undetected on routine investigations.
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