What is the clinical evidence from this study?

Study design: Observational. Population: Myocarditis. Primary outcome: Global incidence rate of myocarditis (EAPC -0.16%, 95% CI -0.18 to -0.14).

What question did this study set out to answer?

The research aims to characterize global and regional trends of myocarditis in those aged 15-39 between 1990 and 2021, and forecast future trends.

March 30, 2026Open Access

Global, regional and national burden of myocarditis in adolescents and young adults, 1990–2021: systematic analysis of the global burden of disease study 2021

Key Result

While the global incidence rate of myocarditis among individuals aged 15-39 years declined slightly (EAPC -0.16%) from 1990 to 2021, the absolute number of incident cases increased by 30.12%.

Key Points

The research aims to characterize global and regional trends of myocarditis in those aged 15-39 between 1990 and 2021, and forecast future trends.
Utilized data from the Global Burden of Disease study on myocarditis incidence and mortality among ages 15-39.
Analyzed data stratified by region, country, age, and sociodemographic index.
Employed segment regression and log-linear models to estimate annual percentage changes.
349,033.33 incident cases reported in 2021 globally, with a notable incidence rate of 13.66 per 100,000 in high SDI regions.
Mortality recorded at 3,300.73 deaths, with East Asia having the highest regional mortality.
DALYs totaled 208,644.28, and the highest incidence was in the 30–34 years age group; mortality peaked in the 35–39 years age group.

Study Design

Type

Observational

Structured PICO

Population

Individuals aged 15–39 years worldwide

Outcome

Incidence, mortality, and disability-adjusted life years (DALYs) attributable to myocarditishard clinical

Despite declining incidence and mortality rates, the absolute burden of myocarditis in adolescents and young adults is increasing globally, highlighting the need for targeted public health strategies.

Main Result

Effect estimate: EAPC -0.16% (95% CI -0.18 to -0.14)

Limitations

Absence of race and ethnicity data in the GBD database
Temporal changes in diagnostic practices and disease surveillance capacity
Evolving diagnostic criteria and ICD coding practices across countries over time

Abstract

Objective This study aims to systematically characterize the global, regional, and national trends of myocarditis among individuals aged 15–39 years between 1990 and 2021, identify associated influencing factors, and forecast future burden through 2050. Findings from this research are expected to support the development of evidence-based health policies and enhance resource allocation for this vulnerable population. Methods Data on incidence, mortality, and disability-adjusted life years (DALYs) attributable to myocarditis among individuals aged 15–39 years were obtained from the Global Burden of Disease (GBD) study. Analyses were stratified by region, country, age, sex, and sociodemographic index (SDI) to explore heterogeneity across populations. Temporal trends were evaluated by estimating the annual percentage change (APC) using the Segment regression model, with the estimated average annual percentage change (EAPC) calculated through log-linear models for robustness. Results There were 349,033.33 incident cases of myocarditis in adolescents and young adults worldwide in 202195% uncertainty interval (UI), 235,755.91–494,002.44. Mortality was recorded at 3,300.73 deaths (95% UI, 2,643.01–4,256.11), while DALYs totaled 208,644.28 (95% UI, 169,653.92–267,518.34). The high SDI region recorded the highest incidence rate among the five SDI categories, reaching 13.66 per 100,000 population (95% UI, 9.84–18.62). The greatest number of myocarditis-related deaths occurred regionally in East Asia (1,097.59; 95% UI, 726.99–1,426.58). India reported the most incident cases at the national level (71,257.12; 95% UI, 46,817.01–100,807.05). In 2021, the incidence, mortality, and DALYs of myocarditis were all higher in men than in women. The highest incidence was observed in the 30–34 years age group, whereas the 35–39 years age group had the highest mortality and DALYs. Both high and low temperatures were found to be significant risk factors for myocarditis in this group, based on the 2021 GBD data. Frontier analyses indicate that there is potential for alleviating the burden of myocarditis in adolescents and young adults, considering national and regional levels of development. Through 2050, incidence and DALYs rates are expected to continue to drop. Conclusion While global incidence, mortality, and DALYs rates of myocarditis among adolescents and young adults have shown a declining trend, the numbers of incident cases, deaths, and DALYs continue to rise. Enhancing the understanding of its epidemiological characteristics can facilitate more effective prevention and control strategies.

Bookmark

View Full Paper