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Impact of the Coronavirus Disease 2019 (COVID-19) Pandemic on Infective Endocarditis Outcomes in Japan: A Nationwide

Takahiro Kuno1, Yoshiaki Ohyama1,2, Yoko Sumita3

  • 1Department of Cardiovascular Medicine, Gunma University Graduate School of Medicine Gunma Japan.

Circulation Reports
|April 13, 2026
PubMed

Insights

The COVID-19 pandemic did not significantly alter in-hospital mortality for infective endocarditis (IE) patients in Japan after risk adjustment. While unadjusted mortality was higher post-pandemic, valve surgery rates remained stable, though stroke incidence increased.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Public Health

Background:

  • Infective endocarditis (IE) poses a significant mortality risk.
  • The COVID-19 pandemic has impacted healthcare systems globally.
  • The effect of the pandemic on IE outcomes in Japan is not well understood.

Purpose of the Study:

  • To assess the impact of the COVID-19 pandemic on in-hospital mortality for IE patients in Japan.
  • To evaluate changes in valve surgery rates among IE patients during the pandemic.
  • To analyze the association between the pandemic and IE patient outcomes in Japan.

Main Methods:

  • Retrospective analysis of the Japanese registry of all Cardiac and Vascular Diseases Diagnostic Procedure Combination (JROAD-DPC) database.
  • Inclusion of 19,077 adult patients hospitalized with IE from April 2016 to March 2022.
  • 1:1 propensity score matching to compare pre-COVID-19 and post-COVID-19 periods (6,652 pairs).

Main Results:

  • Unadjusted in-hospital mortality was higher in the post-COVID-19 period (15.7% vs. 13.9%, P<0.001).
  • Risk-adjusted in-hospital mortality showed no significant difference between periods (15.7% vs. 15.3%, P=0.60).
  • Valve surgery rates (26.4% vs. 25.5%, P=0.22) and stroke incidence (8.3% vs. 7.3%, P=0.049) were analyzed.

Conclusions:

  • Risk-adjusted in-hospital mortality for infective endocarditis was not significantly different during the COVID-19 pandemic in Japan.
  • Unadjusted mortality was higher in the post-pandemic period, suggesting confounding factors.
  • The study highlights the importance of risk adjustment in evaluating pandemic-related healthcare impacts.
Abstract

Keywords:
COVID-19Infective endocarditisMortalityNationwide databaseValve surgery

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