CHARACTERISTICS OF COVID-19 INFECTION-RELATED MYOCARDITIS: AN UPDATED SYSTEMATIC REVIEW

ABSTRACT

SESSION TITLE Late Breaking Posters in Critical Care SESSION TYPE Original Investigation Posters PRESENTED ON 10/18/2022 0130 pm - 0230 pm PURPOSE: This systematic review aims to better understand the clinical characteristics, comorbidities, diagnostic findings, and clinical outcomes associated with COVID-19 myocarditis. METHODS: A search for “COVID-19 OR SARS COV-2 OR Coronavirus AND Myocarditis” was performed on 1/4/2022. 2011 studies from Embase and 1165 studies from PubMed were identified. Selection criteria included studies on SARS COV-2 infection-related myocarditis. 142 PubMed and 104 Embase studies were identified. Studies were appraised per protocols and s, vaccine-related myocarditis, uncertain vaccine/infection-related myocarditis, and, systematic reviews. Duplicate studies were removed. A total of 53 articles from which 57 cases were selected to be part of this systematic review. Data on age, sex, days since diagnosis, comorbid conditions such as morbid obesity, hypertension, hyperlipidemia, CAD, preexisting CHF, ischemic heart disease, D- Dimer, ferritin, high sensitivity troponin, BNP, EKG, echocardiogram, cMRI findings, medications, ventilation requirements, and mortality were extracted from 57 studies and were analyzed using IBM SPSS v26. RESULTS: Mean EF was 32.65 ± 16.57 %. EKG findings of diffuse ST elevation were present in 22% of all cases. Echocardiogram findings of diffuse hypokinesis present in 42.1% and depressed EF in 31.6% of all cases. 21.1% required non-invasive ventilation while 26.3% of all cases ended up requiring mechanical ventilation. Ischemic cardiomyopathy was present in 1.7%, Hypertension in 24.5%, Hyperlipidemia in 7%, Morbid obesity, and a previous diagnosis of CHF was present in 0% of all cases. Overall mortality was seen in 5.3% of all cases. 50% of the cases reported using cardiac MRI (cMRI) and 58% with reported cMRI findings met the Lake Louis criteria for diagnosis of myocarditis. CONCLUSIONS: This systematic review presents findings of demographics, comorbidities, diagnostic findings, and clinical outcomes of adult COVID-19 patients with myocarditis. The mean days since COVID-19 diagnosis has a wide range due to varied presentations noted in case reports. The previously presumed high-risk factors for COVID-19-related myocarditis are not present in a significant percentage of the cases. SARS-CoV2 myocarditis-related mortality is lower in cases than expected. In the setting of the appropriate clinical context, acute/subacute chest pain, with elevated cardiac biomarkers, abnormal EKGs, and echocardiogram findings in patients with recent or /remote SARS-CoV2 infection/ vaccination, a clinical diagnosis of myocarditis can be made in absence of cMRI. CLINICAL IMPLICATIONS Diagnosis of SARS-CoV2-related myocarditis can be made based on clinical presentation, abnormal EKG, and echocardiogram with or without the added benefit of cardiac MRI. This systematic review aims to update current knowledge on the characteristics of COVID-19 infection-related myocarditis. DISCLOSURES No relevant relationships by Mubashir Ayaz Ahmed No relevant relationships by Hari Bhattarai No relevant relationships by shyam chalise No relevant relationships by Saral Desai No relevant relationships by Shayet Hossain Eshan No relevant relationships by Sudha Misra No relevant relationships by Zahin Islam Rafa No relevant relationships by Shrungavi Ramanathan No relevant relationships by Monica Sharma