Prevalence and clinical outcomes of myocarditis and pericarditis in 718,365 COVID-19 patients

Buckley, Benjamin ORCID: 0000-0002-1479-8872, Harrison, Stephanie ORCID: 0000-0002-8846-0946, Fazio-Eynullayeva, Elnara, Underhill, Paula, Lane, Deirdre ORCID: 0000-0002-5604-9378 and Lip, Gregory (2021) Prevalence and clinical outcomes of myocarditis and pericarditis in 718,365 COVID-19 patients. European Journal of Clinical Investigation, 51 (11). e13679-.

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Abstract

<h4>Background</h4>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.<h4>Methods and results</h4>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.<h4>Conclusions</h4>Patients with COVID-19 who present with myocarditis/pericarditis associate with increased odds of major adverse events and new-onset cardiovascular sequelae.

Item Type:	Article
Uncontrolled Keywords:	cardiovascular sequelae, COVID-19, MACE, myocarditis, pericarditis
Divisions:	Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User:	Symplectic Admin
Date Deposited:	13 Sep 2021 07:46
Last Modified:	18 Jan 2023 21:28
DOI:	10.1111/eci.13679
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3136667