{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T13:53:27Z","timestamp":1781272407941,"version":"3.54.1"},"reference-count":82,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T00:00:00Z","timestamp":1690416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Science and Higher Education of the Russian Federation","award":["075-15-2022-301"],"award-info":[{"award-number":["075-15-2022-301"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Myocarditis is characterized by dysfunction and destruction of cardiomyocytes, infiltrative inflammation, and development of fibrosis. Late diagnosis of myocarditis has been a serious global health problem, especially due to the spread of a new coronavirus infection. The aim of this review is to identify differences between myocarditis of viral etiology, including SARS-CoV-2 lesions, based on instrumental and pathomorphological findings. Material and Methods: We analyzed publications covering the period from December 2019 to May 2023, published in publicly accessible international databases (\u201cMedline\u201d, \u201cPubMed\u201d, \u201cScopus\u201d), with queries for the keywords \u201cmyocarditis\u201d, \u201cchildren\u201d, \u201ccardiovascular inflammation\u201d, \u201cCOVID-19\u201d, \u201cSARS-CoV-2\u201d, \u201csevere acute respiratory syndrome coronavirus 2\u201d, \u201cdifferential diagnosis\u201d. Results: It was found that no unambiguous morphological criteria for the diagnosis of myocarditis coupled to SARS-CoV-2 lesions were identified. However, the detected histopathological changes such as virus-associated degeneration, apoptosis, cardiomyocyte necrosis, moderate interstitial hyperemia, myocardial tissue oedema, and capillary endothelial cell dysfunction were the major markers of SARS-CoV-2 infection. Conclusion: It is necessary further reconsider morphological criteria to diagnose SARS-CoV-2-caused myocarditis, rather than solely relying on detecting viral RNA by PCR as the sole evidence-based criterion. Similar issues accompany diagnostics of myocardial lesions associated with other viral infections. Evidence for an etiological diagnosis of myocarditis can be provided by a comprehensive analysis of the diagnostic criteria obtained, confirming virus exposure, followed by development of distinct clinical symptoms, MRI and CT changes, and morphological criteria.<\/jats:p>","DOI":"10.3390\/diagnostics13152499","type":"journal-article","created":{"date-parts":[[2023,7,28]],"date-time":"2023-07-28T01:56:16Z","timestamp":1690509376000},"page":"2499","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Features of Myocarditis: Morphological Differential Diagnosis in Post-COVID-19 Children"],"prefix":"10.3390","volume":"13","author":[{"given":"Vadim","family":"Karev","sequence":"first","affiliation":[{"name":"Children\u2019s Clinical Research Center for Infectious Diseases, St. Petersburg 194100, Russia"},{"name":"Almazov National Medical Research Centre, St. Petersburg 197341, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia Ya","family":"Starshinova","sequence":"additional","affiliation":[{"name":"Pediatric Faculty, State Pediatric Medical University, St. Petersburg 194100, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anzhela","family":"Glushkova","sequence":"additional","affiliation":[{"name":"Medical Faculty, Pavlov First Saint Petersburg State Medical University, St. Petersburg 197022, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1878-4467","authenticated-orcid":false,"given":"Dmitry","family":"Kudlay","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Institute of Pharmacy, I.M. Sechenov First Moscow State Medical University, Moscow 119991, Russia"},{"name":"Institute of Immunology FMBA of Russia, Moscow 115478, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Starshinova","sequence":"additional","affiliation":[{"name":"Almazov National Medical Research Centre, St. Petersburg 197341, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Malkova, A., Kudlay, D., Kudryavtsev, I., Starshinova, A., Yablonskiy, P., and Shoenfeld, Y. (2021). Immunogenetic Predictors of Severe COVID-19. Vaccines, 9.","DOI":"10.3390\/vaccines9030211"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Starshinova, A., Malkova, A., Zinchenko, U., Kudlai, D., Glushkova, A., Dovgalyk, I., Yablonskiy, P., and Shoenfeld, Y. (2021). 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