Association Between COVID-19 and Myocarditis Using Hospital-Based Administrative Data - United States, March
Insights
COVID-19 significantly increases the risk of myocarditis (heart muscle inflammation), with risk varying by age. This highlights the importance of COVID-19 prevention strategies like vaccination.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Myocarditis, an inflammation of the heart muscle, is often caused by viral infections.
- Emerging evidence suggests a link between COVID-19 and myocarditis.
- Myocarditis can lead to severe outcomes including hospitalization, heart failure, and sudden death.
Purpose of the Study:
- To assess the association between COVID-19 and myocarditis.
- To quantify the risk of myocarditis in patients with and without COVID-19.
- To examine age-specific risks of myocarditis in the context of COVID-19.
Main Methods:
- Utilized a large U.S. hospital-based administrative database covering over 900 hospitals.
- Analyzed inpatient encounters for myocarditis from 2019 and 2020.
- Compared myocarditis risk between patients diagnosed with COVID-19 and those without during March 2020-January 2021, adjusting for patient and hospital factors.
Main Results:
- Myocarditis inpatient encounters increased by 42.3% in 2020 compared to 2019.
- Patients with COVID-19 had a 15.7 times higher risk of myocarditis compared to those without.
- The risk ratio for myocarditis varied significantly by age, being higher in younger (<16 years) and older (≥75 years) groups.
Conclusions:
- COVID-19 is significantly associated with an increased risk of myocarditis.
- The risk of myocarditis associated with COVID-19 varies across different age groups.
- Implementing COVID-19 prevention strategies, including vaccination, is crucial to mitigate public health impacts and complications like myocarditis.
Abstract:
Viral infections are a common cause of myocarditis, an inflammation of the heart muscle (myocardium) that can result in hospitalization, heart failure, and sudden death (1). Emerging data suggest an association between COVID-19 and myocarditis (2-5). CDC assessed this association using a large, U.S. hospital-based administrative database of health care encounters from >900 hospitals. Myocarditis inpatient encounters were 42.3% higher in 2020 than in 2019. During March 2020-January 2021, the period that coincided with the COVID-19 pandemic, the risk for myocarditis was 0.146% among patients diagnosed with COVID-19 during an inpatient or hospital-based outpatient encounter and 0.009% among patients who were not diagnosed with COVID-19. After adjusting for patient and hospital characteristics, patients with COVID-19 during March 2020-January 2021 had, on average, 15.7 times the risk for myocarditis compared with those without COVID-19 (95% confidence interval [CI] = 14.1-17.2); by age, risk ratios ranged from approximately 7.0 for patients aged 16-39 years to >30.0 for patients aged <16 years or ≥75 years. Overall, myocarditis was uncommon among persons with and without COVID-19; however, COVID-19 was significantly associated with an increased risk for myocarditis, with risk varying by age group. These findings underscore the importance of implementing evidence-based COVID-19 prevention strategies, including vaccination, to reduce the public health impact of COVID-19 and its associated complications.
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