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

Karsten Keller1,2,3, Ingo Sagoschen1, Stavros Konstantinides2,4

  • 1Department of Cardiology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.

Journal of Medical Virology
|March 9, 2023
PubMed

Insights

Myocarditis occurred in 0.13% of hospitalized coronavirus disease 2019 (COVID-19) patients in Germany in 2020. Risk factors included younger age, male sex, pneumonia, and multisystemic inflammation, with myocarditis increasing fatality risk.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Myocarditis is a known cardiac complication of COVID-19.
  • Real-world data on myocarditis incidence and risk factors in hospitalized COVID-19 patients are limited.

Purpose of the Study:

  • To determine the incidence of myocarditis in hospitalized COVID-19 patients in Germany.
  • To identify risk factors associated with myocarditis in this population.
  • To assess the impact of myocarditis on in-hospital case-fatality.

Main Methods:

  • Analysis of the German nationwide inpatient sample for hospitalizations with confirmed COVID-19 in 2020.
  • Stratification of patients to identify those with myocarditis.
  • Statistical analysis to determine incidence, risk factors, and case-fatality.

Main Results:

  • A total of 176,137 hospitalizations for COVID-19 were analyzed, with 226 (0.13%) cases of myocarditis.
  • The incidence of myocarditis was 1.28 per 1000 hospitalization cases.
  • Patients with myocarditis were younger, and myocarditis was independently associated with a 1.89-fold increased case-fatality.
  • Independent risk factors for myocarditis included age <70 years, male sex, pneumonia, and multisystemic inflammatory COVID-19 infection.

Conclusions:

  • The incidence of myocarditis in hospitalized COVID-19 patients in Germany in 2020 was 1.28 per 1000 hospitalizations.
  • Younger age, male sex, pneumonia, and multisystemic inflammation are key risk factors for developing myocarditis in COVID-19 patients.
  • Myocarditis significantly increases the risk of in-hospital death among COVID-19 patients.

Keywords:
COVID-19SARS-CoV-2incidenceinfectionmyocarditis

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