Coronavirus

Viral Myocarditis

Virology

Cardiology

Myocarditis

Coronavirus disease 2019 (COVID-19)

Immunology

Inflammation

Infectious disease (medical specialty)

Medicine

Disease

Pathogenesis

Pathology

JACC Basic to Translational Science

There is ongoing debate as to whether cardiac complications of coronavirus disease-2019 (COVID-19) result from myocardial viral infection or are secondary to systemic inflammation and/or thrombosis. We provide evidence that cardiomyocytes are infected in patients with COVID-19 myocarditis and are susceptible to severe acute respiratory syndrome coronavirus 2. We establish an engineered heart tissue model of COVID-19 myocardial pathology, define mechanisms of viral pathogenesis, and demonstrate that cardiomyocyte severe acute respiratory syndrome coronavirus 2 infection results in contractile deficits, cytokine production, sarcomere disassembly, and cell death. These findings implicate direct infection of cardiomyocytes in the pathogenesis of COVID-19 myocardial pathology and provides a model system to study this emerging disease.

SARS-CoV-2 Infects Human Engineered Heart Tissues and Models COVID-19 Myocarditis