Produção Nacional
Revisado por pares
COVID-19–Associated cardiac pathology at the postmortem evaluation: a collaborative systematic review
2022; Elsevier BV; Volume: 28; Issue: 8 Linguagem: Inglês
10.1016/j.cmi.2022.03.021
ISSN1469-0691
AutoresRaghed Almamlouk, Tarek Kashour, Sawsan Obeidat, Melanie C. Bois, Joseph J. Maleszewski, Osama Omrani, Rana Tleyjeh, Elie F. Berbari, Zaher Chakhachiro, Bassel Zein‐Sabatto, Dana Gerberi, Imad M. Tleyjeh, Alberto Paniz‐Mondolfi, Aloke V. Finn, Amaro Nunes Duarte‐Neto, Amy Rapkiewicz, Andrea Frustaci, Arthur-Atilla Keresztesi, Brian Hanley, Bruno Märkl, Christelle Lardi, Clare Bryce, Diana Lindner, Diego Aguiar, Dirk Westermann, Edana Stroberg, Eric J. Duval, Esther Youd, Gaetano Bulfamante, Isabelle Salmon, Johann Auer, Joseph J. Maleszewski, Klaus Hirschbühl, Lara Absil, Lisa M. Barton, Luiz Fernando Ferraz da Silva, Luiza Moore, Marisa Dolhnikoff, Martin Lammens, Melanie C. Bois, Michael Osborn, Myriam Remmelink, Paulo Hilário Nascimento Saldiva, Philippe G. Jorens, Randall Craver, Renata Aparecida de Almeida Monteiro, Roberto Scendoni, Sanjay Mukhopadhyay, Tadaki Suzuki, Thaís Mauad, Tony Fracasso, Zachary Grimes,
Tópico(s)SARS-CoV-2 and COVID-19 Research
ResumoBackgroundMany postmortem studies address the cardiovascular effects of COVID-19 and provide valuable information, but are limited by their small sample size.ObjectivesThe aim of this systematic review is to better understand the various aspects of the cardiovascular complications of COVID-19 by pooling data from a large number of autopsy studies.Data sourcesWe searched the online databases Ovid EBM Reviews, Ovid Embase, Ovid Medline, Scopus, and Web of Science for concepts of autopsy or histopathology combined with COVID-19, published between database inception and February 2021. We also searched for unpublished manuscripts using the medRxiv services operated by Cold Spring Harbor Laboratory.Study eligibility criteriaArticles were considered eligible for inclusion if they reported human postmortem cardiovascular findings among individuals with a confirmed SARS coronavirus type 2 (CoV-2) infection.ParticipantsConfirmed COVID-19 patients with post-mortem cardiovascular findings.InterventionsNone.MethodsStudies were individually assessed for risk of selection, detection, and reporting biases. The median prevalence of different autopsy findings with associated interquartile ranges (IQRs).ResultsThis review cohort contained 50 studies including 548 hearts. The median age of the deceased was 69 years. The most prevalent acute cardiovascular findings were myocardial necrosis (median: 100.0%; IQR, 20%–100%; number of studies = 9; number of patients = 64) and myocardial oedema (median: 55.5%; IQR, 19.5%–92.5%; number of studies = 4; number of patients = 46). The median reported prevalence of extensive, focal active, and multifocal myocarditis were all 0.0%. The most prevalent chronic changes were myocyte hypertrophy (median: 69.0%; IQR, 46.8%–92.1%) and fibrosis (median: 35.0%; IQR, 35.0%–90.5%). SARS-CoV-2 was detected in the myocardium with median prevalence of 60.8% (IQR 40.4-95.6%).ConclusionsOur systematic review confirmed the high prevalence of acute and chronic cardiac pathologies in COVID-19 and SARS-CoV-2 cardiac tropism, as well as the low prevalence of myocarditis in COVID-19.
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