A case of severe cardiomyopathy due to COVID-induced myocarditis, completely resolved after colchicine and immunoglobulin therapy
  • Su Khine
    Department of Internal Medicine, Hurley Medical Center, Flint, Michigan, USA
  • Srujan Edupuganti
    Department of Internal Medicine-Pediatrics, Hurley Medical Center, Flint, Michigan, USA
  • Ghassan Bachuwa
    Department of Internal Medicine, Hurley Medical Center, Flint, Michigan, USA

Keywords

COVID-19 myocarditis, non-ischemic cardiomyopathy, ventricular tachycardia, colchicine, immunotherapy

Abstract

Coronavirus 19 (COVID-19) is well known for causing acute respiratory distress syndrome. Among other systemic complications, myocarditis is a frequently reported presentation as well as complication. One systematic review reported a 14% mortality rate in patients with COVID-19 myocarditis. Endomyocardial biopsy is a definitive diagnostic test but has been a challenge to perform in most cases of COVID myocarditis due to the contagious nature of the disease. Patients presenting with new cardiomyopathy with troponin leak and arrhythmias, supported by recent COVID-19 diagnosis should be suspected for COVID-induced myocarditis. Supportive treatment has been the mainstay of treatment with limited data on immunotherapy and colchicine. Our case is about a male in his 50s who had a cardiac arrest due to ventricular fibrillations, with a positive COVID-19 test. Further workup showed severe non-ischaemic cardiomyopathy with an EF of 15–20%. He was treated with intravenous immunotherapy and colchicine. A repeat echocardiogram 3 days later showed resolution of cardiomyopathy. Our case report highlights the possible beneficial effects of immunotherapy and colchicine in viral myocarditis.

VIEW THE ENTIRE ARTICLE

References

  • Cascella M, Rajnik M, Aleem A, Dulebohn SC, Di Napoli R. Features, evaluation, and treatment of Coronavirus (COVID-19) [Internet]. StatPearls. 2023. Available from: http://www.ncbi.nlm.nih.gov/pubmed/23770275
  • Haussner W, DeRosa AP, Haussner D, Tran J, Torres-Lavoro J, Kamler J, et al. COVID-19 associated myocarditis: a systematic review. Am J Emerg Med 2022;51150–155. doi: 10.1016/j.ajem.2021.10.001
  • Hendren NS, Drazner MH, Bozkurt B, Cooper LT Jr. Description and proposed management of the acute COVID-19 cardiovascular syndrome. Circulation 2020;1411903–1914. doi: 1161/CIRCULATIONAHA.120.047349
  • Siripanthong B, Nazarian S, Muser D, Deo R, Santangeli P, Khanji MY, et al. Recognizing COVID-19-related myocarditis: the possible pathophysiology and proposed guideline for diagnosis and management. Heart Rhythm 2020;17:1463–1471. doi: 10.1016/j.hrthm.2020.05.001
  • Ho JS, Sia C-H, Chan MY, Lin W, Wong RC. Coronavirus-induced myocarditis: a meta-summary of cases. Heart Lung 2020;49:681–685. doi: 10.1016/j.hrtlng.2020.08.013
  • Caforio ALP, Pankuweit S, Arbustini E, Basso C, Gimeno-Blanes J, Felix SB, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J 2013;34:2636–2648. doi: 10.1093/eurheartj/eht210
  • Anton-Vazquez V, Byrne L, Anderson L, Hamzah L. COVID-19 cardiac injury and the use of colchicine. BMJ Case Rep 2021;14:e241047. doi: 10.1136/bcr-2020-241047
  • Jalal AM, Aref SF, Albustany DA. Effectiveness of colchicine among patients with COVID-19 infection: a randomized, open-labeled, clinical trial. Indian J Rheumatol 2022;17:136–141. doi: 10.4103/injr.injr_264_21
  • Gültekin N, Kucukates E. Microtubule inhibition therapy by colchicine in severe myocarditis especially caused by Epstein-Barr and cytomegalovirus co-infection during a two-year period: a novel therapeutic approach. J Pak Med Assoc 2014;64:1420–1423
  • Kow CS, Hasan SS. Glucocorticoid versus immunoglobulin in the treatment of COVID-19-associated fulminant myocarditis. Infection 2020;48:805–806. doi: 10.1007/s15010-020-01441-4
  • Views: 451
    PDF downloads: 334
    HTML downloads: 72


    Published: 2023-08-02
    Issue: 2023: Vol 10 No 9 (view)


    How to cite:
    1.
    Khine S, Edupuganti S, Bachuwa G. A case of severe cardiomyopathy due to COVID-induced myocarditis, completely resolved after colchicine and immunoglobulin therapy. EJCRIM 2023;10 doi:10.12890/2023_003877.

    Most read articles by the same author(s)