Canadian Journal of Infectious Diseases and Medical Microbiology

Review Article

Fulminant Myocarditis with SARS-CoV-2 Infection: A Narrative Review from the Case Studies

Table 1

Literature review of cases with fulminant myocarditis with SARS-CoV-2 infection.
CaseAuthorYear (reference)Age (years)SexComorbiditiesDose of vaccinationInitial symptomsTime (symptoms to diagnosis of myocarditis)PneumoniaLVEF (%)PELVWTArrhythmiaCMRBiopsy findingsCatecholamineAntiviral treatmentImmunomodulatory therapyMCSDuration of MCS use (days)Cardiac recoveryOutcome
1Noone et al.2022 [8]38FNone0Cold-like symptoms and relapsing syncope5No<20YesYesNone——Yes——VA-ECMO
Impella CP		8FullyAlive
2Hoang et al.2022 [9]42FND3Chest pain, dyspnea, lethargy, and fever8No25NoNoVF——NoNoNoVA-ECMO7FullyAlive
3De Smet et al.2022 [10]25MNone2Fever, abdominal pain, vomiting, and diarrhea6NoModerately decreased LVEFYesNoNoneModerately dilated left ventricle with moderately reduced systolic function, increased myocardial extracellular volume by T1-mapping, no focal myocardial LGE—YesNoCorticosteroid
IVIG		No—FullyAlive
4Usui et al.2022 [11]44FNone0Chest pain5No10YesYesNoneDiffuse oedematous wall thickening with high signal intensity in T2-weighted images, LGE in the basal to the apical inferolateral mid-myocardial wall—YesRemdesivirCorticosteroid baricitinibVA-ECMO
Impella CP		10FullyAlive
5Ardiana and Aditya2022 [12]40MNoneNDChest pain3NoNDYesYesCAVB——YesNo—IABP6FullyAlive
6Ya’Qoub et al.2022 [13]30MNDNDHeart failure symptomsNDND10NDNDVF——ND——VA-ECMO—NDND
7Ajello et al.2022 [14]49MNoneNDFever and dyspnea4No10NoNDNDDiffuse increase of native T2 and native T1, no LGELymphomonocytic inflammatory infiltrates with cardiomyocytes necrosisYesNoNoImpella CP/5.0/RP10FullyAlive
8Asakura et al.2022 [15]49MNoneNDChest pain6No<20NoYesNoneMild LGE on the epicardial side of the inferior wall of the heart base, mild high signal on T2-weighted MRI of the same area, mild high signal on T1-weighted MRI, mild fibrosis, and edema-like changesMild myocyte hypertrophy, some subendocardial fibrosis, and scattered cluster of differentiation 3 (CD3)-positive T cellsYesNoMethylprednisoloneImpella 5.010FullyAlive
9Nakatani et al.2022 [16]49MNone1Sore throat, chill, and fever4Yes<20NDYesNone—Mild lymphocytic infiltration and moderate to severe perivascular fibrosis with wall thickening of intramural arteriolesYesNoMethylprednisolone, IVIGECMO5—Dead
10Callegari et al.2022 [17]15MNoneNDReduced appetite, gastroenteritis, mild dyspnoea, and dizziness13No20YesNoVTNo myocardial oedema or myocardial contrast enhancementThe histological results were not consistent with an acute/chronic lymphocytic, eosinophilic, or giant-cell myocarditis, or dilated cardiomyopathyYesNoNoNo—FullyAlive
11Phan et al.2022 [18]9MNoneNDFever, cough, and sore throat4No18NDNDNone——YesNoDexamethasoneVA-ECMO10FullyAlive
12Carrasco-Molina et al.2022 [19]36MNDNDDyspnea and chest pain7No30NoNoNoneMyocardial inflammationLymphocytic inflammatory infiltrate (35 CD3+/mm2 lymphocytes), without myocyte necrosis or fibrosisYesNoMethylprednisoloneNo—FullyAlive
13Kohli et al.2022 [20]15FNoneNDHeadache, vomiting, and fatigue1No20 (LVSF)NoNoAF——Yes—Methylprednisolone, IVIG, and anakinraNo—LVSF 34%Alive
14Bhardwaj et al.2022 [21]22MND0NDNDND25NDNDPEA——NDRemdesivirSteroidVA-ECMO5FullyAlive
15Bhardwaj et al.2022 [21]53FND0NDNDND5NDNDNone——NDRemdesivirSteroidVA-ECMO9LVEF 45%Alive
16Bhardwaj et al.2022 [21]28FND0NDNDND36NDNDPEA——NDRemdesivirSteroid, IVIG, and tocilizumabVA-ECMO5FullyDead
17Bhardwaj et al.2022 [21]27FND0NDNDND22NDNDNone——NDRemdesivirSteroid and IVIGVA-ECMO10FullyAlive
18Bhardwaj et al.2022 [21]46MND0NDNDND8NDNDNone——NDRemdesivirSteroid and IVIGVA-ECMO6LVEF 30%Dead
19Bhardwaj et al.2022 [21]68MND0NDNDND20NDNDNone——NDNoSteroidVA-ECMO2NDAlive
20Bhardwaj et al.2022 [21]26FND1NDNDND10NDNDPEA——NDNoSteroidVA-ECMO9FullyAlive
21Bhardwaj et al.2022 [21]66MND0NDNDND10NDNDVT, VF——NDNoSteroidVA-ECMO8FullyAlive
22Bhardwaj et al.2022 [21]24MND0NDNDND15NDNDVF——NDNoSteroidVA-ECMO7FullyAlive
23Mejia et al.2022 [22]17FNDNDND—NoNDNDYesNone——NDNoNoVA-ECMO10NDAlive
24Rajpal et al.2022 [23]60FAsthmaNDFatigue, shortness of breath, and palpitations9No<15YesYesVTDiffuse hyperintensity on T2 mappingScattered perivascular and interstitial inflammatory cells consisting of CD3-positive T-lymphocytes, CD20 positive B-lymphocytes, and histiocytes, along with interstitial and myocyte injuryYesNoMethylprednisoloneVA-ECMO10FullyAlive
25Buitrago et al.2022 [24]12FNoneNDHeadache, neck pain, nausea, diarrhea, and lethargy2NoReducedNoNoPVC/VT—Severe myocarditis without signs of viral infection with severe and diffuse accumulation of CD3 positive T cellsYesNoMethylprednisoneVA-ECMO7StableAlive
26Thomson et al.2022 [25]39FOvarian disease0Diarrhoea, vomiting, and abdominal pain3NoNear ventricular standstillYesYesPEA—Mild interstitial infiltrate consisting mostly of CD68+ macrophages along with a lesser number of CD3+ T cellsYesNoMethylprednisolone, IVIG, and tocilizumabVA-ECMO9—Dead
27Rodriguez Guerra et al.2022 [26]56MHT and DMNDSyncope<7NoNDNDNDLong QT——YesNoNoNo1—Dead
28Verma et al.2022 [27]48FNDNDShortness of breath and chest pressure5No15YesYesNone—Cardiomyocyte damage with prominent macrophage infiltrates. The presence of SARS-CoV-2 in cardiomyocyte is confirmed by RNA scope detecting SARS-CoV-2 spike S antisense strainYesRemdesivirMethylprednisolone and tocilizumabVA-ECMO
Impella CP		13FullyAlive
29Edwards et al.2022 [28]10 monthsMTrisomy 18p, monosomy of 8p, and a small conoventricular ventricular septal defectNDUpper respiratory symptoms and fever4NoSeverely diminishedYesYesNoneT2 weighted imaging demonstrated significantly increased myocardial to skeletal muscle signal intensity—YesRemdesivirDexamethasone and IVIGVA-ECMO8FullyAlive
30Aldeghaither et al.2022 [29]39FNoneNDFever, dyspnea, chest pain, and diarrhea28No10–15YesNoNone—Eosinophilic infiltrate of the myocardiumYesNoMethylprednisoloneVA-ECMO
Impella CP
RVAD		9LVEF of 30–35%Alive
31Aldeghaither et al.2022 [29]25MNoneNDDyspnea, fever, and hypotension35No15–20NDNDNone—Mixed inflammatory cells with some eosinophilsYesNoCorticosteroid, IVIG, and anakinraImpella CP5LVEF of 35–40%Alive
32Aldeghaither et al.2022 [29]21MNDNDDyspnea and fever28No5–10NDNDNone—Lymphocytic infiltrateYesNoMethylprednisolone, IVIG, and anakinraVA-ECMO
Impella CP		3LVEF of 45–50%Alive
33Valiton et al.2022 [30]52FRaynaud syndromeNDShortness of breath, chest pain, and dizziness3No25YesYesNone—Thrombotic microangiopathy of the coronary capillaries with endothelial cell activation (endothelitis) characterized by enlarged nuclei and capillary thrombosisYesNoDexamethasoneImpella CP6FullyAlive
34Ismayl et al.2022 [31]53MNoneNDFever and upper respiratory symptoms35No25NDNDND—Diffuse interstitial and perivascular neutrophilic and lymphocytic infiltration with rare eosinophils and rare myocyte necrosisYesNoSteroidsVA-ECMO
Impella CP		5FullyAlive
35Yalcinkaya et al.2022 [32]29MND0Chest painNDNDReduced ejection fractionNDNDNDLeft ventricular apical thrombus, myocardial edemaEosinophilic myocarditisYesNoNDNo—NDAlive
36Nagata et al.2022 [33]13MNoneNDFever and malaise, nausea, and watery diarrhea20No20NDNDIRBBB——YesNoPrednisolone and IVIGNo—NDAlive
37Nishioka and Hoshino2022 [34]15MNoneNDFever, fatigue, and abdominal pain2No25YesNDCAVB, prolonged QT interval, NSVT——YesNoNoVA-ECMO2LVEF 45%Alive
38Shahrami et al.2022 [35]7MNDNDDyspnea10Yes25NoNoAF——YesHydroxychloroquineDexamethasone and IVIG——LVEF 45%Dead
39Menger et al.2022 [36]4FObesityNDRespiratory distress7YesNDNDNDND—The posterior wall of the heart showed small-spot fadingYesRemdesivir and bamlanivimabDexamethasoneVA-ECMO17—Dead
40Vannella et al.2021 [37]26MNoneNDChest pressure, shortness of breath, nausea, vomiting, and chills7No<10NDNDSVT—Myocardial necrosis surrounded by cytotoxic T-cells and tissue-repair macrophagesYes——VA-ECMO——Dead
41Gozar et al.2021 [38]3 daysFNoNoArrhythmia2No30YesNDVT——Yes—Dexamethasone and IVIGNo—FullyAlive
42Shen et al.2021 [39]43MNoNDFever and abdominal pain49No20–25NDNDNoneDiffuse myocardial oedema without delayed myocardial enhancement—YesNoIVIGIABP4FullyAlive
43Ishikura et al.2021 [40]35MNoNDFever and general weakness21No7.4NDNDNone——YesYes (details unknown)Steroid and IVIGVA-ECMO
IABP		7FullyAlive
44Saha et al.2021 [41]25 daysFSepsisNoFever17No40YesNoCardiac arrest——YesNoMethylprednisolone and IVIGNo—LVEF 65%Alive
45Yeleti et al.2021 [42]25MNoneNDFever, abdominal pain, fatigue, and vomiting120No5–10YesNoVTTransmural late gadolinium enhancement of basal-mid anterolateral and inferolateral segmentsLymphocytic myocarditisNDRemdesivir convalescent plasmaMethylprednisoloneBilateral Impellas
VA-ECMO		3NormalAlive
46Gurin et al.2021 [43]26MNDNDFevers, chills, headache, nausea, vomiting, and diarrhea7Yes20YesNoNone—Interstitial edema and inflammatory infiltrate consisting predominantly of interstitial macrophages with scant T-lymphocytesYes—Solumedrol and IVIGNo—LVEF 75%Alive
47Fiore et al.2021 [44]45MNoneNDShortness of breath, confusion, and asthenia5Yes25NoNoNoneSevere impairment of biventricular global function associated with higher values of T1 and T2 mapping, in the absence of late gadolinium enhancementMild lymphohistiocytic inflammatory infiltrate without myocardial necrosisYesHydroxychloroquineAnakinraIABP7LVEF 55%Alive
48Bemtgen et al.2021 [45]18MNoneNDFever, chills, and tachycardia14No25YesNoNone—Significant infiltration of immune cells (CD68+ macrophages and CD3+ T cells)Yes—Dexamethasone, IVIG, and anakinraVA-ECMO
Impella		7FullyAlive
49Tseng et al.2021 [46]5MNoneNoFatigue and vomiting1NoNDNDNDVT——Yes—Methylprednisolone and IVIGVA-ECMO5NDAlive
50Gaudriot et al.2021 [47]38MChronic lymphopeniaNDChest pain and vomiting28Yes25YesYesIRBBBT2 sequences showed diffuse hyperintense myocardium. Late gadolinium enhancement images demonstrated massive, heterogeneous, and predominantly subepicardial enhancement of the left ventricular myocardiumMyocardial necrosis, suppurated lesions, and lymphocytic infiltrationYes—Antilymphocyte serum, corticosteroids, and mycophenolate mofetil (after heart transplantation)VA-ECMO
Impella		8Not recoveredAlive (heart transplantation)
51Menter et al.2021 [48]47FObesityNDUnconscious and apneic7Yes30NDNoVF—Mild diffuse necrotizing myocarditis accompanied by extensive thrombotic microangiopathy of cardiac capillariesYesNoNoNo—NoDead
52Ghafoor et al.2021 [49]54FHT, obesity, and heart failureNDDyspnea, nausea, and vomiting7No10–15NoNoPEA——YesNoNoVA-ECMOND—Dead
53Okor et al.2021 [50]72FHT and chronic obstructive pulmonary diseaseNDShortness of breath7ND20YesNoNone——YesNoMethylprednisoloneNo—LVEF 50%Dead
54Tomlinson et al.2021 [51]13MNoneNDFever, listlessness, abdominal pain, vomiting, diarrhoea, headache, and rash—No53NDNDEctopic wandering atrial pacemaker——YesNoNoNo——Alive
55Sampaio et al.2021 [52]45MNoneNDDyspnea, fever, myalgia, and postural hypotension7YesNormalYesNoAsystole——YesConvalescent plasmaMethylprednisolone, IVIG, and tocilizumabVA-ECMO9FullyAlive
56Apostolidou et al.2021 [53]7FLate preterm birth, central hypothyroidism, failure to thrive, and recurrent respiratory tract infectionsNDHeadache, loss of appetite, abdominal pain, and vomiting3YesFractional shortening 10%YesNoNone—Acute lymphocytic myocarditisYesRemdesivir convalescent plasma, and interferon-γMethylprednisolone, anakinra and extracorporeal hemadsorptionVA-ECMO
Impella		21—Dead
57Kallel et al.2021 [54]26MNoneNDDiarrhea, vomiting, fever, fatigue, and weakness8Yes30YesNoNoneNormal (7 weeks after the treatment)—YesNoNoNo—LVEF 55%Alive
58Bulbul et al.2021 [55]49FNoneNDCough and shortness of breath7Yes25NDNDNone——YesHydroxychloroquine, oseltamivir, lopinavir, and ritonavirMethylprednisolone, IVIG, and tocilizumabVA-ECMO7LVEF 50%Alive
59Gauchotte et al.2021 [56]69MHT, DM, and ischemic heart diseaseNDFever, asthenia, and abdominal pain7No20YesNDND—Abundant myocardium edema and interstitial inflammation, showing a predominance of mononucleated leucocytes, associated with cardiomyocytes dystrophiesYesNoNoVA-ECMO——Dead
60Gulersen et al.2021 [57]31FPregnantNDCough, myalgias, and diarrhea7NoNDYesNDNoneNormal cardiac function (not mentioned about myocarditis)—YesNoDexamethasone and IVIGNo—NormalAlive
61Rasras et al.2021 [58]47FNoneNDDyspnea and leg pain21Yes10NDNDND——YesNoMethylprednisoloneNo—LVEF 30%Alive
62Purdy et al.2021 [59]53MNoneNDCough, fever, and shortness of breath35No25NoNoNone——YesHydroxychloroquineMethylprednisoloneNo—LVEF 60%Alive
63Purdy et al.2021 [59]30FObesityNDFatigue and shortness of breath9Yes45YesNDNone——YesHydroxychloroquineMethylprednisoloneNo—LVEF 55%Alive
64Sivalokanathan et al.2021 [60]37MNoneNDFever, diarrhea, and dizziness30Yes21YesNDNoneLeft ventricular wall thickening, inhomogeneity of T1/T2 mapping values, and patchy non-infarct pattern late gadolinium enhancement in the inferolateral and apical septal walls—YesNoHydrocortisone and IVIGNo—LVEF 70%Alive
65Ruiz et al.2021 [61]35FSystemic sclerosisNDGeneralized malaise, fever, and cough5Yes<10NoNoPEAMyocarditis (no detail)—YesRemdesivirMethylprednisolone and IVIGBilateral impellas14LVEF 60%Alive
66Papageorgiou et al.2021 [62]43MMixed connective tissue diseaseNDFever, cough, and chest pain4No10–15YesNoNone—No evidence of myocarditisYesNoHydrocortisoneVA-ECMO
Impella CP		7NormalAlive
67Ciuca et al.2021 [63]6MNoneNDFever5Yes48YesNoNoneMyocardial interstitial edema in T1/T2 mapping—YesHydroxychloroquineDexamethasone and IVIGNo—FullyAlive
68Garau et al.2021 [64]18FNoneNDNausea and vomiting1No10YesYesNoneLate gadolinium enhancement in basal to midinferior and inferoseptal segmentsA low density of inflammatory cells without myocyte degeneration or necrosisYesHydroxychloroquineMethylprednisolone and IVIGVA-ECMO
IABP		17LVEF 48%Alive
69Hékimian et al.2021 [65]40MObesity and DMNDDyspnea and asthenia2Yes45NDNDNone——YesNDNoVA-ECMO
VV-ECMO		8LVEF 60%Alive
70Hékimian et al.2021 [65]19FNoneNDFever, dyspnea, and cough9Yes30NDNDNone——YesNDNoVV-ECMO15LVEF 50%Alive
71Hékimian et al.2021 [65]22MObesity, DM, and asthmaNDFever, dyspnea, cough, and asthenia1Yes30NDNDNone——NoNDNoVV-ECMO5LVEF 60%Alive
72Hékimian et al.2021 [65]19MNoneNDFever, headache, diarrhea, dyspnea, and asthenia4No15NDNDNone——YesNDNoNo—LVEF 60%Alive
73Hékimian et al.2021 [65]16MNoneNDFever, anosmia, abdominal pain, rash, conjunctivitis, strawberry tongue, chest pain, asthenia, and adenopathy7Yes20NDNDNone——YesNDIVIGNo—LVEF 45%Alive
74Hékimian et al.2021 [65]17MAortic regurgitationNDFever, headache, abdominal pain, diarrhea, dyspnea, asthenia, and conjunctivitis4No20NDNDNone——YesNDCorticosteroid and IVIGNo—LVEF 50%Alive
75Hékimian et al.2021 [65]17FNoneNDChest pain and dyspnea1No20NDNDVT, cardiac arrest——YesNDCorticosteroid and IVIGVA-ECMO—NoDead
76Milla-Godoy et al.2021 [66]45FObesityNDDiarrhea, nausea, and vomiting4Yes10NoNDAsystole——Yes—Methylprednisolone and IVIGNo—NoDead
77Hu et al.2021 [67]37MNDNDChest pain, dyspnea, and diarrhea3Yes27YesNDNone——YesNoMethylprednisoloneand IVIGNo—LVEF 66%Alive
78Marcinkiewicz et al.2021 [68]20MNoneNDFever and dyspnea42ND15NoYesNoneMyocardial signal was globally increased on T2-weighted imaging. Delayed late gadolinium imaging showed diffuse fibrosis in the anteroseptal and inferior walls—NDNoNoVA-ECMO
IABP		6LVEF 69%Alive
79Gay et al.2020 [69]56MObesity, HLNDDyspnea and lethargy1Yes<5YesYesND——ND—Methylprednisolone and tocilizumabVA-ECMO
Impella 2.5/5.0 ProtekDuo		12LVEF 65%Alive
80Jacobs et al.2020 [70]48MHTNDFever, diarrhea, cough, dysosmia, and dyspnea7YesNDNoYesND—Hypertrophic cardiac tissue with patchy muscular, sometimes perivascular, and slightly diffuse interstitial mononuclear inflammatory infiltrates, dominated by lymphocytesYesNo—VA-ECMO—NoDead
81Lozano Gomez et al.2020 [71]53MNoneNDFever and dyspnea10No10NDNDAF——YesNoNoNo—NoDead
82Tiwary et al.2020 [72]30MHT, DM, chronic kidney disease, glaucoma, and obesityNDAbdominal flank pain and shortness of breathNDYesNDYesNDLBBB——YesRemdesivir and convalescent plasmaDexamethasoneNo—NDAlive
83Othenin-Girard et al.2020 [73]22MNoneNDAsthenia, chills, diffuse myalgia, abdominal pain, and diarrhea5NoNDYesNDCAVB—A severe myocardial inflammation with several foci of myocyte necrosisYes—Methylprednisolone, IVIG, tocilizumab, and cyclophosphamideVA-ECMO5Recovered but not in detailAlive
84Albert et al.2020 [74]49MNoneNDFevers, myalgias, and dyspnea14No20NDYesNone—Mild infiltration of mononuclear cells in the endocardium and myocardium with >14 inflammatory cells per mm2 indicating myocarditisYesNoMethylprednisolone and IVIGVA-ECMO
Impella CP		4NormalAlive
85Salamanca et al.2020 [75]44MNoneNDDyspnea and syncope7Yes15YesNoCAVBDiffuse edema with slightly less involvement of the inferolateral wall on T2 weighted image. T1 mapping with diffuse increase of native T1Isolated interstitial infiltrate with lymphocytes CD3+YesNoNoVA-ECMO
IABP		6LVEF 75%Alive
86Khatri and Wallach2020 [76]50MHT and ischemic strokeNDFevers, chills, generalized malaise, nonproductive cough, and dyspnea4YesNDYesNDNone——YesHydroxychloroquine and methylene blueMethylprednisolone and IVIGNo—NoDead
87Bernal-Torres et al.2020 [77]38FNoneNDPalpitation and general malaise3Yes30YesNDNoneInflammatory manifestations—YesHydroxychloroquine, lopinavir, and ritonavirMethylprednisolone and IVIGNo—LVEF 60%Alive
88Chitturi et al.2020 [78]65FHT, DM, HL, obesity, transient ischaemic attack, and breast cancerNDFever, cough, and shortness of breath14Yes25YesNoNone——YesNoHydrocortisone and tocilizumabNo—LVEF 64%Alive
89Zeng et al.2020 [79]63MAllergic coughNDFever, shortness of breath, and chest tightnessNDYes32NoNDND——YesLopinavir and ritonavirMethylprednisolone, IVIG, and interferon α-1bVA-ECMO—LVEF 68%Dead
90Singhavi et al.2020 [80]20MNoneNDFever1No30NoYesND——YesNDMethylprednisoloneNo—NDAlive
91Naneishvili et al.2020 [81]44FNoneNDFever, lethargy, muscle aches, and syncope3Yes37YesYesAF——YesNoMethylprednisoloneNo—NormalAlive
92Chao et al.2020 [82]49MNoneNDFever and coughNDYes40NoNoRBBB——YesHydroxychloroquineTocilizumabVV-ECMO12LVEF 55%Alive
93Yan et al.2020 [83]44FObesityNDFever, cough, and dyspnea7Yes40NoNoNone—Mild myxoid edema, mild myocyte hypertrophy, and focal nuclear pyknosis. Rare foci with few scattered CD45+ lymphocytesYesHydroxychloroquineTocilizumabNo—NDDead
94Kesici et al.2020 [84]2MNoneNDNausea, vomiting, and poor oral intakeNDYesNDYesNoNone——YesNDNDVA-ECMO——Dead
95Garot et al.2020 [85]18MNoneNDCough, fever, fatigue, and myalgiasNDYes30YesYesNoneStrated nodular subepicardial enhancement of the LV basal posterolateral wall on late gadolinium enhancement images—YesHydroxychloroquineNoNo—LVEF 54%Alive
96Coyle et al.2020 [86]57MHTNDShortness of breath, fevers, cough, myalgias, decreased appetite, nausea, and diarrhea7Yes35–40NoNoNoneDiffuse biventricular and biatrial edema with a small area of late gadolinium enhancement—YesHydroxychloroquine and AT-001 (caficrestat)Methylprednisolone and tocilizumabNo—LVEF 82%Alive
97Richard et al.2020 [87]28FDM, asthma, depression, and intravenous drug useNDLethargyNDYes26–30YesYesRBBBMyocardial necrosis, fibrosis, and hyperemia, indicating myocarditis—YesNoMethylprednisoloneImpella4LVEF >55%Alive
98Pascariello et al.2020 [88]19MAutistic spectrum disorderNDFever, cough, diarrhea, and vomitting3Yes15–20NDNDNone——YesHydroxychloroquine, remdesivir, and oseltamivirDexamethasoneNo—LVEF 50%Alive
99Shah et al.2020 [89]19MNoneNDFever, generalized weakness, cough, and shortness of breath7Yes24NoNoNone——YesHydroxychloroquineMethylprednisolone, IVIG, and tocilizumabNo—LVEF 62%Alive
100Veronese et al.2020 [90]51FThalassemia minorNDFever, dyspnea, and palpitations10No30NoYesVT, RBBBShort tau inversion recovery sequences revealed diffuse increased signal intensity suggestive of diffuse edema. Transmural late gadolinium enhancement involved LV basal-lateral and basal-inferior wallsDiffuse lymphocytic inflammatory infiltratesYesNoMethylprednisoloneVA-ECMO
IABP		6FullyAlive
101Hussain et al.2020 [91]51MHTNDFever, cough, fatigue, and dyspneaNDYes20NoNoNone——YesHydroxychloroquineMethylprednisoloneNo—Not recoveredAlive (ongoing treatment)
102Gill et al.2020 [92]65FHT, DM, and breast cancerNDShortness of breath and chest painNDYes25NoNoNone——Yes——IABP—NoDead
103Gill et al.2020 [92]34FNoneNDShortness of breath, chest pain, and weaknessNDNo20YesNoNone——Yes—MethylprednisoloneVA-ECMO4LVEF 60%Alive
104Fried et al.2020 [93]64FHT, HLNDChest pressure2No30YesYesNone——YesHydroxychloroquineNoIABP7LVEF 50%Alive
105Craver et al.2020 [94]17MNoneNDHeadache, dizziness, nausea, and vomiting2NoNDNDNDAsystole—Diffuse inflammatory infiltrates composed of lymphocytes, macrophages, with prominent eosinophilsND—————Dead
106Irabien-Ortiz et al.2020 [95]59FHT, cervical degenerative arthropathy, chronic lumbar radiculopathy, lymph node tuberculosis, and migraineNDFever and chest pain5NoPreservedYesYesAsystole——YesIFN B, lopinavir, and ritonavirMethylprednisolone and IVIGVA-ECMO
IABP		NDFullyAlive (ongoing treatment)
107Tavazzi et al.2020 [96]69MNDNDDyspnoea, persistent cough, and weakness4Yes25NoNoND—Low grade interstitial and endocardial inflammationYes——VA-ECMO
IABP		5Not recoveredDead
108Gomila-Grange et al.2020 [97]39MNDNDFever, right flank pain, and diarrhea6Yes20YesNoNone——YesHydroxychloroquineTocilizumabNo—NormalAlive
AF, atrial fibrillation; CAVB, complete atrioventricular block; CMR, cardiovascular magnetic resonance; DM, diabetes mellitus; F, female; HL, hyperlipidemia; HT, hypertension; IABP, intra-aortic balloon pumping; IRBBB, incomplete right bundle branch block; IVIG, intravenous immunoglobulin; LGE, late gadolinium enhancement; LV, left ventricle; LVEF, left ventricular ejection fraction; LVSF, left ventricular shortening fraction; LVWT, left ventricular wall thickening; M, male; MCS; mechanical circulatory support; ND, not described; NSVT, nonsustained ventricular tachycardia; PE, pericardial effusion; PEA, pulseless electrical activity; PVC, premature ventricular contraction; VA/VV-ECMO, veno-arterial/veno-venous extracorporeal membrane oxygenation; VF, ventricular fibrillation; and VT, ventricular tachycardia.