Researchers have identified two distinct phenotypes of fulminant COVID-19-related myocarditis in adults, with different clinical presentations, immunologic profiles, and outcomes.
Differentiation between the two bioclinical entities is important to understand for patient management and further pathophysiologic studies, they say.
This phenotype occurs weeks after SARS-CoV-2 infection, usually beyond detectable active viral replication in the context of specific immune response and severe systemic inflammation with skin and mucosal involvement. Myocardial dysfunction is more progressive and rarely associated with large pericardial effusions, Gorochov explained.Evolving Understanding
MIS-A– patients also had higher lactate levels, were more likely to need venoarterial ECMO , had higher ICU mortality , and a had lower probability of survival at 3 months compared with their MIS-A+ peers.The immunologic profiles of these two distinct clinical phenotypes also differed.