首页|Fulminant myocarditis induced by SARS-CoV-2 infection without severe lung involvement:insights into COVID-19 pathogenesis

Fulminant myocarditis induced by SARS-CoV-2 infection without severe lung involvement:insights into COVID-19 pathogenesis

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Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection often leads to pulmonary com-plications.Cardiovascular sequelae,including myocarditis and heart failure,have also been reported.Here,the study presents two fulminant myocarditis cases infected by SARS-CoV-2 exhibiting remarkable elevation of cardiac biomarkers without significant pulmonary injury,as determined by imaging examina-tions.Immunohistochemical staining reveals the viral antigen within cardiomyocytes,indicating that SARS-CoV-2 could directly infect the myocardium.The full viral genomes from respiratory,anal,and myocardial specimens are obtained via next-generation sequencing.Phylogenetic analyses of the whole genome and spike gene indicate that viruses in the myocardium/pericardial effusion and anal swabs are closely related and cluster together yet diverge from those in the respiratory samples.In addition,unique mutations are found in the anal/myocardial strains compared to the respiratory strains,suggesting tissue-specific virus mutation and adaptation.These findings indicate genetically distinct SARS-CoV-2 variants have infiltrated and disseminated within myocardial tissues,independent of pulmonary injury,and point to different infection routes between the myocardium and respiratory tract,with myocardial infections potentially arising from intestinal infection.These findings highlight the potential for systemic SARS-CoV-2 infection and the importance of a thorough multi-organ assessment in patients for a comprehensive understanding of the pathogenesis of COVID-19.

COVID-19SARS-CoV-2Fulminant myocarditisMyocardiumInfection

Han Du、Zhongtao Du、Liang Wang、Hong Wang、Mingjun Jia、Chunge Zhang、Yun Liu、Cheng Zhang、Ya Zhang、Ruifeng Zhang、Shuang Zhang、Ning Zhang、Zhenghai Ma、Chen Chen、Wenjun Liu、Hui Zeng、George F.Gao、Xiaotong Hou、Yuhai Bi

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College of Life Science and Technology,Xinjiang University,Urumchi,Xinjiang 830046,China

CAS Key Laboratory of Pathogen Microbiology and Immunology,Institute of Microbiology,Center for Influenza Research and Early-warning(CASCIRE),CAS-TWAS Center of Excellence for Emerging Infectious Diseases(CEEID),Chinese Academy of Sciences,Beijing 100101,China

Beijing Anzhen Hospital,Capital Medical University,Beijing 100029,China

College of Veterinary Medicine,Shanxi Agricultural University,Taiyuan,Shanxi 030031,China

University of Chinese Academy of Sciences,Beijing 100049,China

Beijing Shijitan Hospital,Capital Medical University,Beijing 100038,China

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National Key R&D Program of ChinaNational Key R&D Program of ChinaNational Natural Science Foundation of ChinaBeijing Research Center for Respiratory Infectious DiseasesMajor Project of Guangzhou National LaboratoryMajor Project of Guangzhou National LaboratoryNational Science and Technology Infrastructure of ChinaYouth Innovation Promotion Association of CASCAS Project for Young Scientists in Basic ResearchInnovation Team and Talents Cultivation Program of the National Administration of Traditional Chinese Medicine

2023YFC23075002021YFC270170082341115BJRID2024-003GZNL2023A01001SRPG22-001National Pathogen Resource Center-NPRC-32Y2021034YSBR-086ZYYCXTD-D-202208

2024

10.1016/j.jgg.2024.02.007

遗传学报
中国遗传学会 中国科学院遗传与发育生物学研究所

遗传学报

CSTPCD
影响因子：0.821
ISSN：1673-8527
年,卷(期)：2024.51(6)