Multimodal Assessment of Immunosuppressive Therapy in a Patient with Chronic Active Myocarditis 3 months following COVID-19 Infection

There is limited evidence available regarding the efficacy of immunosuppressive therapy for post Coronavirus disease 2019 (COVID-19) chronic active myocarditis. We present a case of a 28-year-old woman with post COVID-19 virus-negative chronic active myocarditis. Immunosuppressive therapy improved the left ventricular ejection fraction from 21% to 42%, and ameliorated inflammatory activity as assessed by cardiac magnetic resonance imaging (CMR) and endomyocardial biopsy (EMB). This is the first report to evaluate inflammatory activity before and after immunosuppressive therapy in post COVID-19 virus-negative chronic active myocarditis using both EMB and CMR.