What type of study is this?

This is a Cohort Study study (also classified as: Human Clinical Trial, Pre-Registered Trial).

What question did this study set out to answer?

This research aims to evaluate cardiovascular manifestations and mortality outcomes in patients with leptospirosis.

May 6, 2026Open Access

Cardiovascular manifestations and outcomes in patients with leptospirosis admitted to a tertiary care center in the Coastal Karnataka region in India

Key Points

This research aims to evaluate cardiovascular manifestations and mortality outcomes in patients with leptospirosis.
Retrospective study design
Inclusion of adult patients with clinically suspected leptospirosis and positive IgM ELISA
Clinical features and ECG findings analyzed
Echocardiographic parameters assessed
Binomial logistic regression used to identify predictors of mortality
A total of 510 patients analyzed with mean age 48.4 years
In-hospital mortality rate observed was 8%
Sinus tachycardia and myocarditis were independent predictors of mortality
Acute respiratory distress syndrome occurred in 10.6%
Elevated QT interval and specific ventricular dysfunction were noted in echocardiograms

Abstract

INTRODUCTION: Leptospirosis is a globally prevalent zoonotic infection caused by Leptospira species. Cardiac involvement is increasingly recognized, yet large-scale studies comprehensively evaluating electrocardiographic and echocardiographic manifestations, including myocarditis, remain limited. METHODS: This retrospective study included adult patients with clinically suspected leptospirosis and positive IgM ELISA admitted to a tertiary care hospital in South India between January 2016 and September 2020. Clinical features, electrocardiographic (ECG) findings, two-dimensional echocardiographic parameters, and in-hospital outcomes were analyzed. Binomial logistic regression was performed to identify independent predictors of all-cause mortality and myocarditis. RESULTS: A total of 510 patients were analyzed (mean age 48.4 ± 13.7 years; 66.5% male). The mean hospital stay was 10.1 ± 6.1 days, with 40% requiring hospitalization beyond 10 days. Diabetes mellitus and hypertension were present in 16.7% and 16.9% of patients, respectively. Acute respiratory distress syndrome occurred in 10.6%, and 28% developed multiorgan dysfunction syndrome; 17.8% required hemodialysis. The most common ECG abnormalities were corrected QT interval prolongation (21.0%) and sinus tachycardia (20.8%). Echocardiographic evidence of myocarditis was observed in 10.4% of patients, including isolated left ventricular dysfunction (4.1%), isolated right ventricular dysfunction (3.9%), and biventricular dysfunction (2.4%). The overall in-hospital mortality rate was 8%. Increasing age, sinus tachycardia, QTc prolongation, hypertension, hemodialysis requirement, and myocarditis were independent predictors of mortality. CONCLUSIONS: Myocarditis represents a significant cardiac complication in leptospirosis and is associated with increased mortality. Routine cardiac evaluation may facilitate early detection and risk stratification. CLINICAL TRIAL REGISTRATION: Not applicable, as this study was retrospective in nature.

Cardiovascular manifestations and outcomes in patients with leptospirosis admitted to a tertiary care center in the Coastal Karnataka region in India

Key Points

Abstract

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