While COVID-19 is known to have a wide spectrum of cardiovascular sequelae, including myocarditis and pericarditis, less is known about the virus’ prevalence and clinical impact. Researchers of a study published in the European Journal of Clinical Investigation investigated the prevalence of new-onset myocarditis/pericarditis and associated adverse cardiovascular events in patients with COVID-19.
Researchers conducted a retrospective cohort study using electronic medical records from a global federated health research network. Inclusion criteria was a diagnosis of COVID-19 and new-onset myocarditis or pericarditis. Patients were propensity score matched 1:1 with respect to age, sex, race, and comorbidities to patients with COVID-19 but without myocarditis/pericarditis.
The primary outcomes were six-month all-cause mortality, hospitalization, cardiac arrest, incident heart failure, incident atrial fibrillation and acute myocardial infarction in patients with and without myocarditis/pericarditis. Overall, the study consisted of 718,365 patients with COVID-19, of which 5.0% developed new-onset myocarditis and 1.5% developed new-onset pericarditis.
Six-month all-cause mortality was 3.9% in patients with myocarditis and 2.9% in matched controls (odds ratio [OR]=1.36, 95% confidence interval [CI] 1.21-1.53, P<0.0001). The six-month all-cause mortality was 15.5% for pericarditis and 6.7% in matched controls (OR=2.55, 95% CI 2.24-2.91, P<0.0001).
The researchers noted that 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.
“Patients with COVID-19 who present with myocarditis/pericarditis associate with increased odds of major adverse events and new-onset cardiovascular sequelae,” the investigators concluded.
Keywords: COVID-19, MACE, cardiovascular sequelae, myocarditis, pericarditis