{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:49:12Z","timestamp":1753876152026,"version":"3.41.2"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T00:00:00Z","timestamp":1612742400000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Coronavirus disease 2019 (COVID-19) myocarditis is emerging as a component of the hyperactive inflammatory response secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Isolated gastrointestinal symptoms are uncommon presenting features in adults with COVID-19 myocarditis. The availability of antibody testing is a valuable addition to the confirmation of COVID-19, when repeated reverse transcriptase\u2013polymerase chain reaction of nasopharyngeal swabs are negative.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A young healthcare worker presented with dizziness and pre-syncope, 4 weeks after his original symptoms that included fever, lethargy, and diarrhoea. Despite 2 weeks of isolation, followed by a quiescent spell, his symptoms had returned. Shortly after, he presented in cardiogenic shock (left ventricular ejection fraction 25%), that required vasopressor support, at the height of the COVID-19 pandemic. Cardiac magnetic resonance imaging suggested florid myocarditis. Three nasopharyngeal swabs (Days 1, 3, and 5) were negative for SARS-CoV-2, but subsequent serology (Day 13) confirmed the presence of SARS-CoV-2 IgG. Treatment with intravenous immunoglobulin and glucocorticoids led to full recovery.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Our case study highlights the significance of the use of the available serological assays for diagnosis of patients presenting late with SARS-CoV-2. Importantly, it supports further research in the use of immunomodulatory drugs for the hyperinflammatory microenvironment induced by COVID-19.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab013","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T19:23:31Z","timestamp":1612812211000},"source":"Crossref","is-referenced-by-count":1,"title":["Gastroenteritis and cardiogenic shock in a healthcare worker: a case report of COVID-19 myocarditis confirmed with serology"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3227-3295","authenticated-orcid":false,"given":"Sanjay","family":"Sivalokanathan","sequence":"first","affiliation":[{"name":"Cardiovascular Clinical Academic Group, St George's, University of London and St George\u2019s University Hospitals NHS Foundation Trust, Cranmer Terrace, Tooting, London SW17 0RE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0330-5542","authenticated-orcid":false,"given":"Michael","family":"Foley","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, W12 0HS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graham","family":"Cole","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, W12 0HS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8297-556X","authenticated-orcid":false,"given":"Taryn","family":"Youngstein","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, W12 0HS, 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