Premium
Prevalence and clinical outcomes of myocarditis and pericarditis in 718,365 COVID‐19 patients
Author(s) -
Buckley Benjamin J.R.,
Harrison Stephanie L.,
FazioEynullayeva Elnara,
Underhill Paula,
Lane Deirdre A.,
Lip Gregory Y.H.
Publication year - 2021
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13679
Subject(s) - medicine , pericarditis , myocarditis , odds ratio , cardiology , atrial fibrillation , retrospective cohort study
Background COVID‐19 has a wide spectrum of cardiovascular sequelae including myocarditis and pericarditis; however, the prevalence and clinical impact are unclear. We investigated the prevalence of new‐onset myocarditis/pericarditis and associated adverse cardiovascular events in patients with COVID‐19. Methods and results A retrospective cohort study was conducted using electronic medical records from a global federated health research network. Patients were included based on a diagnosis of COVID‐19 and new‐onset myocarditis or pericarditis. Patients with COVID‐19 and myocarditis/pericarditis were 1:1 propensity score matched for age, sex, race and comorbidities to patients with COVID‐19 but without myocarditis/pericarditis. The outcomes of interest were 6‐month all‐cause mortality, hospitalisation, cardiac arrest, incident heart failure, incident atrial fibrillation and acute myocardial infarction, comparing patients with and without myocarditis/pericarditis. Of 718,365 patients with COVID‐19, 35,820 (5.0%) developed new‐onset myocarditis and 10,706 (1.5%) developed new‐onset pericarditis. Six‐month all‐cause mortality was 3.9% (n = 702) in patients with myocarditis and 2.9% (n = 523) in matched controls ( p < .0001), odds ratio 1.36 (95% confidence interval (CI): 1.21–1.53). Six‐month all‐cause mortality was 15.5% (n = 816) for pericarditis and 6.7% (n = 356) in matched controls ( p < .0001), odds ratio 2.55 (95% CI: 2.24–2.91). Receiving critical care was associated with significantly higher odds of mortality for patients with myocarditis and pericarditis. Patients with pericarditis seemed to associate with more new‐onset cardiovascular sequelae than those with myocarditis. This finding was consistent when looking at pre‐COVID‐19 data with pneumonia patients. Conclusions Patients with COVID‐19 who present with myocarditis/pericarditis associate with increased odds of major adverse events and new‐onset cardiovascular sequelae.