Myocarditis in SARS-CoV-2 negative patients with suspected preceding infection

BMJ Case Rep. 2021 Jan 12;14(1):e239513. doi: 10.1136/bcr-2020-239513.


SARS-CoV-2 is primarily a respiratory disease; however, there have been multiple reports of associated myocarditis. In our 463 bedded, district general hospital, we noted an influx of young patients with myocarditis shortly after the peak of the outbreak. We report two cases presenting with myocarditis, both of whom tested negative for the virus despite clinical and biochemical evidence of recent infection. Diagnosis was made based on positive transthoracic echocardiogram (TTE) findings and a raised troponin, not in the context of suspected acute coronary syndrome. We recommend that patients with negative coronavirus tests should still be considered at risk of potential sequelae from the disease. There should be a low threshold for performing basic cardiac investigations: ECG, troponin and TTE as well as seeking a cardiology opinion. Colchicine is a recognised treatment for viral pericarditis and should be considered as adjunctive treatment; however, further research is required specific to SARS-CoV-2.

Keywords: infectious diseases; intensive care; pericardial disease.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Asymptomatic Infections
  • COVID-19* / complications
  • COVID-19* / diagnosis
  • COVID-19* / therapy
  • Diagnosis, Differential
  • Humans
  • Male
  • Myocarditis* / diagnosis
  • Myocarditis* / etiology
  • Myocarditis* / therapy