In-Hospital Outcomes of COVID-19 Associated Myocarditis (from a Nationwide Inpatient Sample Database Study)

Sattar, Yasar; Sandhyavenu, Harigopal; Patel, Neel; Victor, Varun; Patel, Dhruvil; Hussain, Bilal; Titus, Anoop; Thyagaturu, Harshith; Alraiyes, Mowaffak; Atti, Lalitsiri; Ashraf, Shoaib; Patel, Nirav; Gonuguntla, Karthik; Ludhwani, Dipesh; Skaff, Paulina; Zeb, Irfan; Haleem, Affan; Alraies, M. Chadi

doi:10.1016/j.amjcard.2023.01.004

Cited by 3 publications

(5 citation statements)

References 17 publications

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“…In accordance with other studies, 45 our study demonstrated that myocarditis was associated with a 1.5‐fold increase of case‐fatality in COVID‐19 patients independently of age, sex, and comorbidities and with 2.8‐fold in‐crease regarding occurrence of venous thromboembolism. It is well known that COVID‐19 is associated with venous thromboembolism, 47–51 myocarditis seems to increase this risk further.…”

Section: Discussionsupporting

confidence: 92%

“…We identified a case‐fatality rate of 24.3% in patients with confirmed COVID‐19 diagnosis by laboratory test and myocarditis, which is lower than in the in‐hospital mortality rate of COVID‐19‐patients with myocarditis in the United States (31.5%), 45 but higher than the previously published 13.5% in the study of Bemtgen et al 18 (also examining the German nationwide inpatient cohort) but including in contrast to our analysis not only patients with confirmed COVID‐19 diagnosis by laboratory test (but also patients with suspicion of COVID‐19 and typical symptoms without definite confirmation of COVID‐19) as well as post‐COVID myocarditis 18 . The laboratory confirmation of COVID‐19 is an important criteria of this study and a key strength of our and the study of the US 45 . Our results were supported by an analysis of the NIS from the US, revealing that in‐hospital mortality of COVID‐19 patients with myocarditis was higher in comparison to those COVID‐19 patients without myocarditis (OR: 1.59 [95% CI: 1.27−1.90]) 45 and that in‐hospital mortality of patients with COVID‐19 and myocarditis was higher compared to those patients with myocarditis, but without COVID‐19 infection (30.7% vs. 6.4%, OR: 4.8, 95% CI: 3.7−6.3, p < 0.001) 46 …”

Section: Discussionmentioning

confidence: 74%

“…The in‐hospital case‐fatality rate was 1.3‐fold higher in COVID‐19 patients with than without myocarditis. We identified a case‐fatality rate of 24.3% in patients with confirmed COVID‐19 diagnosis by laboratory test and myocarditis, which is lower than in the in‐hospital mortality rate of COVID‐19‐patients with myocarditis in the United States (31.5%), 45 but higher than the previously published 13.5% in the study of Bemtgen et al 18 (also examining the German nationwide inpatient cohort) but including in contrast to our analysis not only patients with confirmed COVID‐19 diagnosis by laboratory test (but also patients with suspicion of COVID‐19 and typical symptoms without definite confirmation of COVID‐19) as well as post‐COVID myocarditis 18 . The laboratory confirmation of COVID‐19 is an important criteria of this study and a key strength of our and the study of the US 45 .…”

Section: Discussionmentioning

confidence: 74%

“…18 The laboratory confirmation of COVID-19 is an important criteria of this study and a key strength of our and the study of the US. 45 Our results were supported by an analysis of the NIS from the US, revealing that in-hospital mortality of COVID-19 patients with myocarditis was higher in comparison to those COVID-19 patients without myocarditis (OR: 1.59 [95% CI: 1.27−1.90]) 45 and that in-hospital mortality of patients with COVID-19 and myocarditis was higher compared to those patients with myocarditis, but without COVID-19 infection (30.7% vs.…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Incidence and risk factors of myocarditis in hospitalized patients with COVID‐19

Keller

Sagoschen

Konstantinides

et al. 2023

Journal of Medical Virology

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Myocarditis as cardiac involvement in coronavirus disease 2019 (COVID-19)infection is well known. Real-world data about incidence in hospitalized COVID-19patients and risk factors for myocarditis in COVID-19-patients are sparse. We used the German nationwide inpatient sample to analyze all hospitalized patients with confirmed COVID-19-diagnosis in Germany in 2020 and stratified them for myocarditis. Overall, 176 137 hospitalizations (52.3% males, 53.6% aged ≥70 years) with confirmed COVID-19-infection were coded in Germany in 2020 and among them, 226 (0.01%) had myocarditis (incidence: 1.28 per 1000 hospitalization-cases).Absolute numbers of myocarditis increased, while relative numbers decreased with age. COVID-19-patients with myocarditis were younger (64.0 [IQR: 43.0/78.0] vs. 71.0 [56.0/82.0], p < 0.001). In-hospital case-fatality was 1.3-fold higher in COVID-19-patients with than without myocarditis (24.3% vs. 18.9%, p = 0.012).

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 74%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Incidence and risk factors of myocarditis in hospitalized patients with COVID‐19

Keller

Sagoschen

Konstantinides

et al. 2023

Journal of Medical Virology

View full text Add to dashboard Cite

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“…Within a span of 2–3 months following SARS-CoV-2 infection, 19% of patients developed persistent symptoms of myocarditis [ 150 ]. One year after rehabilitation, patients had a significant 4.16-fold increased risk of myocarditis [ 151 ] and poorer clinical outcomes, with a mortality rate of 1.36% to 5% [ 152 ]. The direct pathogenic mechanism of myocarditis in long COVID is the direct interaction of SARS-CoV-2 with ACE2 receptors in cardiomyocytes and pericytes, causing immune dysregulation.…”

Section: Therapeutic Potential Of Naringin and Naringenin In Long Covidmentioning

confidence: 99%

Potential Beneficial Effects of Naringin and Naringenin on Long COVID—A Review of the Literature

Liu,

Zhong,

et al. 2024

Microorganisms

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Coronavirus disease 2019 (COVID-19) caused a severe epidemic due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Recent studies have found that patients do not completely recover from acute infections, but instead, suffer from a variety of post-acute sequelae of SARS-CoV-2 infection, known as long COVID. The effects of long COVID can be far-reaching, with a duration of up to six months and a range of symptoms such as cognitive dysfunction, immune dysregulation, microbiota dysbiosis, myalgic encephalomyelitis/chronic fatigue syndrome, myocarditis, pulmonary fibrosis, cough, diabetes, pain, reproductive dysfunction, and thrombus formation. However, recent studies have shown that naringenin and naringin have palliative effects on various COVID-19 sequelae. Flavonoids such as naringin and naringenin, commonly found in fruits and vegetables, have various positive effects, including reducing inflammation, preventing viral infections, and providing antioxidants. This article discusses the molecular mechanisms and clinical effects of naringin and naringenin on treating the above diseases. It proposes them as potential drugs for the treatment of long COVID, and it can be inferred that naringin and naringenin exhibit potential as extended long COVID medications, in the future likely serving as nutraceuticals or clinical supplements for the comprehensive alleviation of the various manifestations of COVID-19 complications.

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Myocarditis and Myocardial Injury in Long COVID Syndrome: A Comprehensive Review of the Literature

Paruchuri,

Farwa,

Jabeen

et al. 2023

Cureus

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The repercussions of coronavirus disease 2019 (COVID-19) have been devastating on a global scale. Long COVID, which affects patients for weeks or even months after their initial infection, is not limited to individuals with severe symptoms and can affect people of all ages. The condition can impact various physiological systems, leading to chronic health conditions and long-term disabilities that present significant challenges for healthcare systems worldwide. This review explores the link between long COVID and cardiovascular complications such as myocardial injury and myocarditis. It also highlights the prevalence of these complications and identifies risk factors for their development in long COVID patients. Myocardial injury occurs due to direct cellular damage and T-cell-mediated cytotoxicity resulting in elevated cardiac biomarkers. Diagnostic techniques like electrocardiogram, troponin level testing, and magnetic resonance imaging can help identify myocarditis, but endomyocardial biopsy is considered the gold-standard diagnostic technique. Guideline-directed medical therapy is recommended for COVID-19 myocarditis patients for better prognosis while being monitored under comprehensive care management approaches. Therefore, it's critical to develop effective screening techniques specifically for vulnerable populations while conducting further research that addresses the effects of long COVID on society's physical health.

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In-Hospital Outcomes of COVID-19 Associated Myocarditis (from a Nationwide Inpatient Sample Database Study)

Cited by 3 publications

References 17 publications

Incidence and risk factors of myocarditis in hospitalized patients with COVID‐19

Incidence and risk factors of myocarditis in hospitalized patients with COVID‐19

Potential Beneficial Effects of Naringin and Naringenin on Long COVID—A Review of the Literature

Myocarditis and Myocardial Injury in Long COVID Syndrome: A Comprehensive Review of the Literature

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