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Elsevier, Annals of Medicine and Surgery, 7(85), p. 3308-3317, 2023

DOI: 10.1097/ms9.0000000000000936

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Outcomes of viral myocarditis in patients with and without COVID-19: a nationwide analysis from the United States

This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Data provided by SHERPA/RoMEO

Abstract

Background: Cardiovascular complications contribute to 40% of coronavirus disease 2019 (COVID-19) related deaths. The viral myocarditis associated with COVID-19 accounts for significant morbidity and mortality. How COVID-19 myocarditis compares to other viral myocardites is unknown. Methods: The authors conducted a retrospective cohort study using the National Inpatient Sample database to identify adult patients hospitalized for viral myocarditis in 2020 and to compare outcomes between those with and without COVID-19. The primary study outcome was in-hospital mortality. Secondary outcomes included in-hospital complications, length of stay, and total costs. Results: The study population included 15 390 patients with viral myocarditis, of whom 5540 (36%) had COVID-19. After adjustment for baseline characteristics, patients with COVID-19 had higher odds of in-hospital mortality [adjusted odds ratio (aOR) 3.46, 95% CI 2.57–4.67], cardiovascular complications (aOR 1.46, 95% CI 1.14–1.87) including cardiac arrest (aOR 2.07, 95% CI 1.36–3.14), myocardial infarction (aOR 2.97, 95% CI 2.10–4.20), venous thromboembolism (aOR 2.01, 95% CI 1.25–3.22), neurologic complications (aOR 1.82, 95% CI 1.10–2.84), renal complications (aOR 1.72, 95% CI 1.38–2.13), and hematologic complications (aOR 1.32, 95% CI 1.10–1.74), but lower odds of acute heart failure (aOR 0.60, 95% CI 0.44–0.80). The odds of pericarditis, pericardial effusion/tamponade, cardiogenic shock, and the need for vasopressors or mechanical circulatory support were similar. Patients with COVID-19 had longer length of stay (7 days vs. 4 days, P<0.01) and higher total costs ($21,308 vs. $14,089, P<0.01). Conclusions: Among patients with viral myocarditis, COVID-19 is associated with higher in-hospital mortality and cardiovascular, neurologic, renal, and hematologic complications compared to non-COVID-19 viruses.