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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.

Abstract

In the context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, significant attention was given to pulmonary manifestations. However, cardiac involvement is increasingly recognized as a critical factor influencing the prognosis, leading to myocardial damage, heart failure, acute coronary syndromes, potentially lethal arrhythmic events, and sudden cardiac death. Despite these findings, there is a lack of studies detailing the necroscopic, macroscopic, and microscopic cardiac changes associated with SARS-CoV-2. This study aimed to investigate the presence of SARS-CoV-2 viral proteins in cardiac tissue using immunohistochemical techniques to assess viral tropism. The analysis of cardiac tissue samples from deceased subjects, in different stages of conservation, confirmed to be positive for SARS-CoV-2 via reverse transcriptase-polymerase chain reaction (RT-PCR), showed immunopositivity for the SARS-CoV-2-NP viral antigen in 33% of cases. Notably, the presence of leukocyte infiltrates sufficient for diagnosing lymphocytic myocarditis was not observed. The central proinflammatory cytokines involved in the pathogenetic mechanism of coronavirus disease 19 (COVID-19) were researched using the immunohistochemical method. A significant increase in cytokine expression was detected, indicating myocardial involvement and dysfunction during SARS-CoV-2 infection. These findings suggest that the immunohistochemical detection of SARS-CoV-2 viral antigens and inflammatory cytokine expression in cardiac tissue could be crucial for a proper forensic assessment of the cause of death, even in sudden cardiac death.

Details

Title
Cardiac SARS-CoV-2 Infection, Involvement of Cytokines in Postmortem Immunohistochemical Study
Author
Alfieri, Letizia 1   VIAFID ORCID Logo  ; Franceschetti, Lorenzo 2   VIAFID ORCID Logo  ; Frisoni, Paolo 3 ; Bonato, Omar 4 ; Radaelli, Davide 5 ; Bonuccelli, Diana 6 ; Stefano D’Errico 5   VIAFID ORCID Logo  ; Neri, Margherita 1   VIAFID ORCID Logo 

 Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; [email protected] 
 Institute of Legal Medicine, Department of Biomedical Sciences for Health, University of Milan, 20133 Milano, Italy 
 Unit of Legal Medicine, AUSL Romagna, G.B. Morgagni-L. Pierantoni Hospital, 47100 Forlì, Italy; [email protected] 
 Unit of Legal Medicine, AULSS 5 Polesana, 45100 Rovigo, Italy; [email protected] 
 Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy; [email protected] (D.R.); [email protected] (S.D.) 
 Department of Legal Medicine, Territorial Unit USL Toscana Nord-Ovest, 55100 Lucca, Italy; [email protected] 
First page
787
Publication year
2024
Publication date
2024
Publisher
MDPI AG
e-ISSN
20754418
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
3046822584
Copyright
© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.