Asunto(s)
Isquemia Encefálica/complicaciones , Infecciones por Coronavirus/complicaciones , Neumonía Viral/complicaciones , Accidente Cerebrovascular/complicaciones , Adulto , Betacoronavirus , Isquemia Encefálica/mortalidad , COVID-19 , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pandemias , Prevalencia , SARS-CoV-2 , Accidente Cerebrovascular/mortalidad , Análisis de SupervivenciaAsunto(s)
COVID-19/complicaciones , Insuficiencia Cardíaca/mortalidad , Insuficiencia Cardíaca/virología , Cobertura de Afecciones Preexistentes , SARS-CoV-2/patogenicidad , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , COVID-19/diagnóstico , COVID-19/mortalidad , Enfermedad Crónica/mortalidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tasa de SupervivenciaRESUMEN
OBJECTIVE: To present a large registry data assessing the association between myocarditis and mortality in patients with severe acute respiratory syndrome coronavirus 2 infection. PATIENTS AND METHODS: The researchers identified adult patients aged 18 to 90 years of age with coronavirus disease 2019 (COVID-19) diagnosis in the TriNetX (COVID-19 research network) database between January 20, 2020, and December 9, 2020. These patients were then divided into groups of those who had a positive myocarditis diagnosis and those who did not. The researchers compared all-cause mortality between propensity-matched pairs of patients in both groups. RESULTS: A total of 259,352 patients with COVID-19 diagnosis were included in the study. Of those patients, 383 (0.2%) had myocarditis diagnosis, whereas 258,969 (99.8%) did not have myocarditis diagnosis during their hospital stay. Patients were predominantly male in the myocarditis group (59.0% vs 45.0%, P<0.001). As to the propensity-matched cohorts, 383 of 383 were matched, and the all-cause mortality was 13.4 % vs 4.2% (P<0.001) at 30 days. A Kaplan-Meier survival analysis was also statistically significant (P<0.001) at 30 days. CONCLUSION: In a large multinational database of COVID-19 patients, we observed an association between myocarditis diagnosis and increased mortality. Further prospective studies are recommended to further assess myocarditis outcomes in COVID-19 patients and treatment options.
Asunto(s)
COVID-19 , Oxigenación por Membrana Extracorpórea , Femenino , Humanos , Masculino , SARS-CoV-2 , Caracteres SexualesAsunto(s)
Estenosis de la Válvula Aórtica/cirugía , Válvula Aórtica/cirugía , COVID-19/epidemiología , Prótesis Valvulares Cardíacas , Reemplazo de la Válvula Aórtica Transcatéter/tendencias , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Estenosis de la Válvula Aórtica/epidemiología , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenAsunto(s)
Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus , Control de Infecciones/organización & administración , Pandemias , Manejo de Atención al Paciente/métodos , Neumonía Viral , COVID-19 , Prueba de COVID-19 , Técnicas de Laboratorio Clínico/métodos , Infecciones por Coronavirus/diagnóstico , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/terapia , Humanos , Pandemias/prevención & control , Grupo de Atención al Paciente/organización & administración , Neumonía Viral/diagnóstico , Neumonía Viral/prevención & control , Neumonía Viral/terapia , SARS-CoV-2 , Evaluación de Síntomas/métodosRESUMEN
OBJECTIVES: To confirm whether a relationship exists between male sex and coronavirus disease 2019 (COVID-19) mortality and whether this relationship is age dependent. PATIENTS AND METHODS: We queried the COVID-19 Research Network, a multinational database using the TriNetX network, to identify patients with confirmed COVID-19 infection. The main end point of the study was all-cause mortality. RESULTS: A total of 14,712 patients were included, of whom 6387 (43%) were men. Men were older (mean age, 55.0±17.7 years vs 51.1±17.9 years; P<.001) and had a higher prevalence of hypertension, diabetes, coronary disease, obstructive pulmonary disease, nicotine dependence, and heart failure but a lower prevalence of obesity. Before propensity score matching (PSM), all-cause mortality rate was 8.8% in men and 4.3% in women (odds ratio, 2.15; 95% CI, 1.87 to 2.46; P<.001) at a median follow-up duration of 34 and 32 days, respectively. In the Kaplan-Meier survival analysis, the cumulative probability of survival was significantly lower in men than in women (73% vs 86%; log-rank, P<.001). After PSM, all-cause mortality remained significantly higher in men than in women (8.13% vs 4.60%; odds ratio, 1.81; 95% CI, 1.55 to 2.11; P<.001). In the Kaplan-Meier survival analysis, the cumulative probability of survival remained significantly lower in men than in women (74% vs 86%; log-rank, P<.001). The cumulative probability of survival remained significantly lower in propensity score-matched men than in women after excluding patients younger than 50 years and those who were taking angiotensin-converting enzyme inhibitor or angiotensin receptor blocker medications on admission. CONCLUSION: Among patients with COVID-19 infection, men had a significantly higher mortality than did women, and this difference was not completely explained by the higher prevalence of comorbidities in men.