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Risk factors for myocarditis hospitalization and recurrence: a state-wide retrospective observational study
Timothy Nathan Kwan1, Gemma Kwan2, David Brieger1
1Department of Cardiology, Concord Hospital, The University of Sydney, 1 Hospital Road, Concord, Sydney, NSW 2139, Australia.
European Heart Journal Open
|November 13, 2025
Summary
Myocarditis risk increases after conditions like COVID-19, autoimmune diseases, and cardiac events. Recurrence is linked to similar conditions, not index admission factors.
Area of Science:
- Cardiology
- Epidemiology
- Immunology
Background:
- Myocarditis is a serious heart condition with varied causes, including infections and autoimmune responses.
- Understanding risk factors for initial myocarditis hospitalization and subsequent recurrence is crucial for patient management.
Purpose of the Study:
- To quantify risk factors associated with index myocarditis hospitalization.
- To identify risk factors for myocarditis recurrence in patients with a history of the condition.
Main Methods:
- Retrospective cohort study using Australian hospitalization data (2004-2021).
- Conditional logistic regression identified conditions preceding index myocarditis.
- Cox regression and competing risk analysis assessed myocarditis recurrence risk factors.
Main Results:
- 4071 index myocarditis cases identified; 124 experienced recurrence over median 4.8 years.
- Index myocarditis and recurrence were associated with recent hospitalizations for pericarditis, heart failure, ventricular arrhythmias, COVID-19, and autoimmune diseases.
- Recurrence was not strongly predicted by index myocarditis admission characteristics.
Conclusions:
- Myocarditis diagnosis frequently follows acute respiratory illness (including COVID-19), autoimmune conditions, and cardiac events.
- These associated conditions are key considerations for both initial diagnosis and predicting recurrence.
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