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Supplementary Figure 1. Predisposition and factors contributing to the development of myocarditis in COVID-19. AVC = Arrhythmogenic ventricular cardiomyopathy; SLE = Systemic lupus erythematosus. Modified with permission from: Trachtenberg BH, Hare JM. Inflammatory cardiomyopathic syndromes. Circ Res. 2017;121(7):803-18.Supplementary Table 1: 9 case reports of coronavirus-related myocarditisCase report Corona-virus species Patient profile ECG finding(s)cTnI (ng/L)NT-proBNP (ng/L)Echo finding(s) CMR finding(s)Key treatment(s)Outcome(s)Kim et al. (2020)5SARS-CoV-221-year-old femaleIntraventricular conduction delay, multiple PVC1,2601,929Severe LV dysfunctionMyocardial thickening (edema), extensive LGE present. N/ACardiac CT showed normal coronary arteries but myocardial edema and subendocardial perfusion defect in LV. Sala et al. (2020)6SARS-CoV-243-year-old femaleAtrial ectopy, mild ST elevation in V1, V2 and aVR, reciprocal ST depression in V4-V6, QTc = 452 ms, diffuse U wave135512LVEF = 43%, inferolateral wall hypokinesia(performed on day 7 of admission) LVEF = 52%, mild hypokinesia at basal an mid left ventricular segments. diffused myocardial edema, no LGE Lopinavir/ritonavir, Hydroxychloroquine, Continuous positive airway pressure.EMB showed diffused T-lymphocyte infiltrates, interstitial edema and foci of necrosis. SARS-CoV-2 absent in the sample. LVEF returned to 65%, normalized ECG, cardiac enzymes. Patient discharged day 13.Inciardi et al. (2020)4SARS-CoV-253-year-old femaleDiffuse ST elevation (inferior and lateral leads), ST-segment depression with T-wave inversion in V1 and aVR590?8,465Increased LV wall thickness, diffused hypokinesiaIncreased wall thickness with diffuse biventricular hypokinesia,LVEF = 35%, Marked myocardial edema on T2-weighted imaging, diffuse LGE involving the entire biventricular wall, pericardial effusion around right cardiac chambersDobutamine, Lopinavir/Ritonavir, IV prednisolone, chloroquine, heart failure treatments (furosemide, canrenone, bisoprolol)Reduction of LV wall thickness and LVEF = 44% (by day 6 after treatment)Zeng et al. (2020)3SARS-CoV-2 63-year-old maleSinus tachycardiaraised? 22,600Enlarged left ventricle, diffused myocardial dyskinesia, LVEF = 32%N/AECMO, Methylprednisolone, IVIG, Lopinavir/ Ritonavir, Interferon α-1bcTnI = 0.10 g/LNT-proBNP = 750 ng/LLVEF = 63%(14 days after treatment)Hu et al. (2020)48Unspecified coronavirus37-year-old maleST elevation>10,00021,025Enlarged heart, ventricular dysfunction with LVEF = 27%N/AMethylprednisolone, IVIG, Norepinephrine, Milrinone,DiureticcTnI = 220.5 ng/LNT-proBNP = 1,586 ng/LLVEF = 66% (7 days after treatment)Alhogbani (2016)15MERS-CoV60-year-old malesinus tachycardia with diffuse T-wave inversion1,1308,906Severe global left ventricular systolic dysfunction, small pericardial effusionLGE in the subepicardial region of LV inferior and lateral wallsMechanical ventilation, Furosemide LV systolic remained severely impaired but patient appeared clinically stable at discharge (3 months after treatment)Rao et al. (2014)47Unspecified coronavirus9-month-old maleST elevationN/AN/ALVEF = 25%N/AECMO, Balloon Atrial septostomy, IVIG,LVEF = 55%(6 days after treatment)Chantreuil et al. (2013)13CoV-NL633-month-old maletachy-arrhythmiaN/A4,069 §Left ventricular dilatation LVEF = 35%N/AMechanical ventilation, Milrinone, Levosimendan, Digoxin, AmiodaroneLVEF = 61%Restored sinus rhythm (10 days after treatment)Riski et al. (1980)14CoV-O4343-year-old maleST-elevation, inverted T wavesN/AN/APericardial effusion N/AN/AClinical recovery reported circa 2 months after admission?high sensitivity cTnT reported? value reported as raised by the authors (11.37 g/L)§B-type Natriuretic Peptide reportedAbbreviations: cTnI = Cardiac troponin I, CoV-NL63 = Coronavirus NL63, CoV-O43 = Coronavirus O43, ECMO = Extracorporeal membrane oxygenation, IV = Intravenous, IVIG = IV immunoglobulin, LGE = Late gadolinium enhancement, LV = Left ventricular, LVEF = LV ejection fraction, NT-proBNP = N-terminal-pro-B-type natriuretic peptide, MERS-CoV = Middle East respiratory syndrome coronavirus, PVC = Premature ventricular contraction, SARS-CoV-2 = Severe acute respiratory syndrome coronavirus 2 ................
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