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Prevalence and clinical outcomes of myocarditis and pericarditis in 718,365 COVID-19 patients.
Buckley, Benjamin J R; Harrison, Stephanie L; Fazio-Eynullayeva, Elnara; Underhill, Paula; Lane, Deirdre A; Lip, Gregory Y H.
  • Buckley BJR; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.
  • Harrison SL; Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
  • Fazio-Eynullayeva E; Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital, Liverpool, UK.
  • Underhill P; Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK.
  • Lane DA; TriNetX LLC., Cambridge, MA, USA.
  • Lip GYH; TriNetX LLC., London, UK.
Eur J Clin Invest ; 51(11): e13679, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1405172
ABSTRACT

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 11 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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pericarditis / Atrial Fibrillation / Mortality / COVID-19 / Heart Arrest / Heart Failure / Myocardial Infarction / Myocarditis Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Eur J Clin Invest Year: 2021 Document Type: Article Affiliation country: Eci.13679

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pericarditis / Atrial Fibrillation / Mortality / COVID-19 / Heart Arrest / Heart Failure / Myocardial Infarction / Myocarditis Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: North America Language: English Journal: Eur J Clin Invest Year: 2021 Document Type: Article Affiliation country: Eci.13679