COVID-19相关心肌炎可能是先前变种的致命并发症，但在Omicron变体中还没有很好的理解。我们介绍了一例未接种COVID-19相关暴发性心肌炎的病例，原因是OmicronBA.2亚谱系需要机械循环支持（MCS）。一名没有接种SARS-CoV-2疫苗的66岁女性因COVID-19住院。第二天,由于暴发性心肌炎的发展，她被转移到我们医院。抵达后,由于血流动力学不稳定，她接受了ImpellaCP和静脉动脉体外膜氧合治疗。除了MCS，我们用直角肌治疗了她，甲基强的松龙,托珠单抗,还有Remdesivir.左心室收缩逐渐改善，并且MCS在第8天被移除。心内膜活检显示CD3+-T淋巴细胞和CD68+-巨噬细胞轻度间质浸润，无明显坏死或纤维化。该病例的组织学特征与Omicron变异型之前的COVID-19相关心肌炎相似。应考虑对Omicron变体进行疫苗接种，以防止严重疾病的发展，包括暴发性心肌炎.
未经评估：尽管Omicron变体被认为通常不那么严重，COVID-19相关暴发性心肌炎，在这种情况下，可以发生。应考虑对Omicron变体进行疫苗接种，以防止发生严重疾病。
COVID-19-associated myocarditis can be a lethal complication in previous variants, but it is not well understood in the Omicron variant. We present an unvaccinated
case of COVID-19-associated fulminant myocarditis due to the Omicron BA.2 sub-lineage requiring mechanical circulatory support (MCS). A 66-year-old female without vaccination against SARS-CoV-2 was hospitalized due to COVID-19. On the next day, she was transferred to our hospital due to the development of fulminant myocarditis. After arrival, she was treated with Impella CP and venoarterial extracorporeal membrane oxygenation due to unstable hemodynamics. In addition to MCS, we treated her with inotropes, methylprednisolone, tocilizumab, and remdesivir. Left ventricular contraction gradually improved, and MCS was removed on day 8. Endomyocardial biopsy showed mild interstitial infiltration of CD3+-T lymphocytes and CD68+-macrophages with no remarkable necrosis or fibrosis. This
case showed similar histological characteristics to COVID-19-associated myocarditis before the Omicron variant. The vaccination against the Omicron variant should be considered to prevent the development of severe illness, including fulminant myocarditis.
UNASSIGNED: Although the Omicron variant is thought to be generally less severe, COVID-19-associated fulminant myocarditis, as in this
case, can occur. The vaccination against the Omicron variant should be considered to prevent from developing severe illness.
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