RENATA APARECIDA DE ALMEIDA MONTEIRO

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LIM/05 - Laboratório de Poluição Atmosférica Experimental, Hospital das Clínicas, Faculdade de Medicina

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  • article 25 Citação(ões) na Scopus
    COVID-19-Associated cardiac pathology at the postmortem evaluation: a collaborative systematic review
    (2022) ALMAMLOUK, Raghed; KASHOUR, Tarek; OBEIDAT, Sawsan; BOIS, Melanie C.; MALESZEWSKI, Joseph J.; OMRANI, Osama A.; TLEYJEH, Rana; BERBARI, Elie; CHAKHACHIRO, Zaher; ZEIN-SABATTO, Bassel; GERBERI, Dana; TLEYJEH, Imad M.; MONDOLFI, Alberto E. Paniz; V, Aloke Finn; DUARTE-NETO, Amaro Nunes; V, Amy Rapkiewicz; FRUSTACI, Andrea; KERESZTESI, Arthur-Atilla; HANLEY, Brian; MAERKL, Bruno; LARDI, Christelle; BRYCE, Clare; LINDNER, Diana; AGUIAR, Diego; WESTERMANN, Dirk; STROBERG, Edana; DUVAL, Eric J.; YOUD, Esther; BULFAMANTE, Gaetano Pietro; SALMON, Isabelle; AUER, Johann; HIRSCHBUEHL, Klaus; ABSIL, Lara; BARTON, Lisa M.; SILVA, Luiz Fernando Ferraz da; MOORE, Luiza; DOLHNIKOFF, Marisa; LAMMENS, Martin; OSBORN, Michael; REMMELINK, Myriam; SALDIVA, Paulo Hilario Nascimento; JORENS, Philippe G.; CRAVER, Randall; MONTEIRO, Renata Aparecida de Almeida; SCENDONI, Roberto; MUKHOPADHYAY, Sanjay; SUZUKI, Tadaki; MAUAD, Thais; FRACASSO, Tony; GRIMES, Zachary
    Background: Many postmortem studies address the cardiovascular effects of COVID-19 and provide valuable information, but are limited by their small sample size. Objectives: The aim of this systematic review is to better understand the various aspects of the cardio-vascular complications of COVID-19 by pooling data from a large number of autopsy studies. Data sources: We searched the online databases Ovid EBM Reviews, Ovid Embase, Ovid Medline, Scopus, and Web of Science for concepts of autopsy or histopathology combined with COVID-19, published be-tween database inception and February 2021. We also searched for unpublished manuscripts using the medRxiv services operated by Cold Spring Harbor Laboratory. Study eligibility criteria: Articles were considered eligible for inclusion if they reported human post-mortem cardiovascular findings among individuals with a confirmed SARS coronavirus type 2 (CoV-2) infection. Participants: Confirmed COVID-19 patients with post-mortem cardiovascular findings. Interventions: None. Methods: Studies were individually assessed for risk of selection, detection, and reporting biases. The median prevalence of different autopsy findings with associated interquartile ranges (IQRs). Results: This review cohort contained 50 studies including 548 hearts. The median age of the deceased was 69 years. The most prevalent acute cardiovascular findings were myocardial necrosis (median: 100.0%; IQR, 20%-10 0%; number of studies = 9; number of patients = 64) and myocardial oedema (median: 55.5%; IQR, 19.5%-92.5%; number of studies = 4; number of patients = 46). The median re-ported prevalence of extensive, focal active, and multifocal myocarditis were all 0.0%. The most prevalent chronic changes were myocyte hypertrophy (median: 69.0%; IQR, 46.8%-92.1%) and fibrosis (median: 35.0%; IQR, 35.0%-90.5%). SARS-CoV-2 was detected in the myocardium with median prevalence of 60.8% (IQR 40.4-95.6%). Conclusions: Our systematic review confirmed the high prevalence of acute and chronic cardiac pathologies in COVID-19 and SARS-CoV-2 cardiac tropism, as well as the low prevalence of myocarditis in COVID-19.