Abstract
COVID-19 has a significant effect upon the cardiovascular system. While a number of different cardiovascular histopathologies have been described at post-mortem examination, the incidence of typical viral myocarditis in COVID-19 positive patients appears very low [1-3]. In this study, we further characterize and quantify the inflammatory cell infiltrate in a COVID-19 study cohort and compare the findings to both an age and disease matched control cohort and a cohort of patients diagnosed with typical inflammatory myocarditis. All study and control cohorts had 1 or more of the comorbidities most commonly associated with severe disease (hypertension, type II diabetes, obesity, or known cardiovascular disease). The results demonstrate a skewed distribution of the number of CD68+ cells in COVID-19 hearts, with upper quantiles showing a significant increase as compared to both matched control hearts, and those with myocarditis. In contrast, hearts from typical inflammatory myocarditis contained increased numbers of CD4+, and CD8+ cells compared to both COVID-19 and control cohorts. In conclusion, the presence of an increased number of CD68+ cells suggests that COVID-19 may incite a form of myocarditis different from typical viral myocarditis, and associated with diffusely infiltrative cells of monocytes/macrophage lineage.
Keywords: CD68 cells; COVID-19; SARS-CoV-2; autopsy, myocarditis, heart, inflammation, macrophages.
【저자키워드】 COVID-19, SARS-CoV-2, CD68 cells, autopsy, myocarditis, heart, inflammation, macrophages., 【초록키워드】 Monocytes, Inflammation, macrophages, obesity, Comorbidities, Comorbidity, cardiovascular disease, cardiovascular system, diabetes, hypertension, Autopsy, Histopathology, Cohort, myocarditis, heart, Lineage, age, Post-mortem, incidence, distribution, disease, Inflammatory, severe disease, matched control, (hypertension, inflammatory cell, Type II Diabetes, viral myocarditis, skewed distribution, significant effect, significant increase, positive patients, cohorts, CD4+, CD68, CD68+ cells, CD8+ cells, hearts, study cohort, while, Cell, described, diagnosed, appear, CD68+ cell, CD8+ cell, cohort of patient, COVID-19 positive patient, infiltrative, skewed, 【제목키워드】 mechanism, Inflammatory, Quantitative analysis,