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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
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COVID-19-Associated Acute Myocarditis: Risk Factors, Clinical Outcomes, and Implications for Early Detection and

Shiwani Kamath1, Mohamad-Hamood T Gomah2, Gauthier Stepman1

  • 1Internal Medicine, Medical Center of Trinity, Trinity, USA.

Cureus
|October 6, 2023
PubMed

Insights

Acute myocarditis is a serious complication of COVID-19, increasing the risk of ventilation and death. Routine cardiac biomarker testing and close monitoring of patients with underlying heart conditions are crucial for better outcomes.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, a disease with multisystem complications, including cardiac issues.
  • Acute myocarditis is a recognized complication of COVID-19, and prior research indicates higher mortality in patients with cardiac involvement.
  • Understanding the impact of myocarditis and pre-existing cardiac conditions on COVID-19 outcomes is critical.

Purpose of the Study:

  • To determine if COVID-19 patients develop myocarditis.
  • To assess the association between myocarditis and increased need for ventilatory support and mortality.
  • To evaluate if pre-existing cardiac conditions worsen outcomes in COVID-19 patients.

Main Methods:

  • A multicenter, retrospective study involving 8,162 adult patients with confirmed COVID-19.
  • Myocarditis was defined by elevated troponin-T (TnT) and brain natriuretic peptide (BNP) levels.
  • Statistical analysis compared in-hospital mortality and ventilatory support rates between COVID-19 patients with and without myocarditis.

Main Results:

  • 1,643 (20.1%) of COVID-19 patients developed new-onset acute myocarditis.
  • Myocarditis significantly increased the risk of requiring ventilation and mortality (p<0.001).
  • Underlying heart failure increased in-hospital mortality by 1.6 times; non-ischemic cardiomyopathy increased mortality by 2.33 times.

Conclusions:

  • Myocarditis is a significant and potentially fatal complication of COVID-19.
  • Routine TnT and BNP testing can help identify at-risk COVID-19 patients.
  • Pre-existing heart conditions are associated with poorer COVID-19 outcomes, necessitating vigilant patient monitoring.

Keywords:
coronavirus disease 2019 (covid-19)covid-19covid-19 and myocarditiscovid-19-induced myocarditismyocarditis

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