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

Buckley, BJR, Harrison, SL, Fazio-Eynullayeva, E, Underhill, P, Lane, DA and Lip, GYH (2021) Prevalence and clinical outcomes of myocarditis and pericarditis in 718,365 COVID-19 patients. European Journal of Clinical Investigation, 51 (11). ISSN 0014-2972

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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 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. Conclusions: 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
Additional Information: This is the peer reviewed version of the following article: Buckley, BJR, Harrison, SL, Fazio-Eynullayeva, E, Underhill, P, Lane, DA, Lip, GYH. Prevalence and clinical outcomes of myocarditis and pericarditis in 718,365 COVID-19 patients. Eur J Clin Invest. 2021; 51:e13679. which has been published in final form at https://doi.org/10.1111/eci.13679. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. This article may not be enhanced, enriched or otherwise transformed into a derivative work, without express permission from Wiley or by statutory rights under applicable legislation. Copyright notices must not be removed, obscured or modified. The article must be linked to Wiley’s version of record on Wiley Online Library and any embedding, framing or otherwise making available the article or pages thereof by third parties from platforms, services and websites other than Wiley Online Library must be prohibited.
Uncontrolled Keywords: Science & Technology; Life Sciences & Biomedicine; Medicine, General & Internal; Medicine, Research & Experimental; General & Internal Medicine; Research & Experimental Medicine; cardiovascular sequelae; COVID-19; MACE; myocarditis; pericarditis; MORTALITY; Humans; Atrial Fibrillation; Myocarditis; Heart Arrest; Myocardial Infarction; Pericarditis; Critical Care; Hospitalization; Severity of Illness Index; Incidence; Mortality; Cause of Death; Case-Control Studies; Retrospective Studies; Cohort Studies; Adult; Aged; Middle Aged; United States; Female; Male; Heart Failure; Propensity Score; COVID-19; SARS-CoV-2; COVID-19; MACE; cardiovascular sequelae; myocarditis; pericarditis; Adult; Aged; Atrial Fibrillation; COVID-19; Case-Control Studies; Cause of Death; Cohort Studies; Critical Care; Female; Heart Arrest; Heart Failure; Hospitalization; Humans; Incidence; Male; Middle Aged; Mortality; Myocardial Infarction; Myocarditis; Pericarditis; Propensity Score; Retrospective Studies; SARS-CoV-2; Severity of Illness Index; United States; 1103 Clinical Sciences; General Clinical Medicine
Subjects: R Medicine > RC Internal medicine > RC1200 Sports Medicine
Divisions: Sport & Exercise Sciences
Publisher: Wiley
SWORD Depositor: A Symplectic
Date Deposited: 17 May 2022 11:55
Last Modified: 17 May 2022 12:00
DOI or Identification number: 10.1111/eci.13679
URI: https://researchonline.ljmu.ac.uk/id/eprint/16821

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