Global, Regional, and National Burden of Myocarditis From 1990 to 2017: A Systematic Analysis Based on the Global Burden of Disease Study 2017

Abstract

Objective: The global trends in myocarditis burden over the past two decades remain poorly understood and might be increasing during the coronavirus disease 2019 (COVID-19) worldwide pandemic. This study aimed to provide comprehensive estimates of the incidence, mortality, and disability-adjusted life years (DALYs) for myocarditis globally from 1990 to 2017.Methods: Data regarding the incidence, mortality, DALY, and estimated annual percentage change (EAPC) between 1990 and 2017 for myocarditis worldwide were collected and calculated from the 2017 Global Burden of Disease study. We additionally calculated the myocarditis burden distribution based on the Socio-Demographic Index (SDI) quintile and Human Development Index (HDI).Results: The incidence cases of myocarditis in 2017 was 3,071,000, with a 59.6% increase from 1990, while the age-standardized incidence rate (ASIR) was slightly decreased. The number of deaths due to myocarditis increased gradually from 27,120 in 1990 to 46,490 in 2017. The middle SDI quintile showed the highest number of myocarditis-related deaths. On the contrary, the global age-standardized death rate (ASDR) decreased with an overall EAPC of −1.4 [95% uncertainty interval (UI) = −1.8 to −1.0]. Similar to ASDR, the global age-standardized DALY rate also declined, with an EAPC of −1.50 (95% UI = −2.30 to −0.8) from 1990 to 2017. However, there was a 12.1% increase in the number of DALYs in the past 28 years; the middle SDI and low-middle SDI quintiles contributed the most to the DALY number in 2017. We also observed significant positive correlations between the EPAC of age-standardized rate and HDI for both death and DALY in 2017.Conclusions: Globally, the ASIR, ASDR, and age-standardized DALY rate of myocarditis decreased slightly from 1990 to 2017. The middle SDI quintile had the highest level of ASIR, ASDR, and age-standardized DALY rate, indicating that targeted control should be developed to reduce the myocarditis burden especially based on the regional socioeconomic status. Our findings also provide a platform for further investigation into the myocarditis burden in the era of COVID-19.

Myopericarditis following COVID-19 vaccination and non-COVID-19 vaccination: a systematic review and meta-analysis

“… 76 In the general population before the COVID-19 pandemic, the incidence of myocarditis was generally higher in males, and highest in young adults. 77 , 78 Thus far, guidelines for COVID-19 vaccine-induced myopericarditis have mainly focused on early diagnosis and treatment, 79 , 80 , 81 , 82 while some have recommended avoiding strenuous exercise for 2 weeks following vaccination. 83 Several national guidelines also highlight the indications and contraindications for vaccine subtypes in this context.…”

COVID-19 vaccination and carditis in children and adolescents: a systematic review and meta-analysis

“…Our team has recently examined the overall rates of myopericarditis in Asia and compared them to those reported in other countries [ 21 , 22 ]. We found that the rate of vaccine-related myopericarditis among adults is similar to the background rate but much lower than COVID-19 infection, while the rate of myopericarditis among 12–15 years old patients was higher [ 21 , 23 ]. However, there has been no systematic evaluation of the paediatric, adolescent or young adult subgroups, which are thought to be affected to greater extents than older adults.…”

A Poroelastic Approach for Modelling Myocardial Oedema in Acute Myocarditis

“…Although multiple agents can cause myocarditis, viral infections are most common ( Caforio et al, 2013 ). The literature reports that the number of myocarditis cases in 2017 was 3,071,000, which represents an increase of about 60% from 1990 ( Wang et al, 2021 ). The disease caused about 47,000 deaths in 2017, against about 27,000 in 1990 ( Wang et al, 2021 ).…”

“…The literature reports that the number of myocarditis cases in 2017 was 3,071,000, which represents an increase of about 60% from 1990 ( Wang et al, 2021 ). The disease caused about 47,000 deaths in 2017, against about 27,000 in 1990 ( Wang et al, 2021 ). Myocarditis affects individuals of all ages ( Wang et al, 2021 ): its prevalence is higher in the young ( Caforio et al, 2013 ), but most of the deaths are observed in elderly individuals ( Wang et al, 2021 ).…”

“…The disease caused about 47,000 deaths in 2017, against about 27,000 in 1990 ( Wang et al, 2021 ). Myocarditis affects individuals of all ages ( Wang et al, 2021 ): its prevalence is higher in the young ( Caforio et al, 2013 ), but most of the deaths are observed in elderly individuals ( Wang et al, 2021 ). Since these numbers were collected before the COVID-19 pandemic, they may increase even more.…”