Key result
COVID-19-associated carditis linked to ~200% higher MACE risk versus COVID-19 without carditis.
Why the study?
While COVID-19 is associated with heightened long-term cardiovascular risk, the long-term prognosis of survivors with clinically confirmed carditis remains poorly characterized.
Does COVID-19-associated carditis increase the risk of MACE and all-cause mortality in COVID-19 survivors compared to those without carditis?
Observational (n=45,191)
Yes
Does COVID-19-associated carditis increase the risk of MACE and all-cause mortality in COVID-19 survivors compared to those without carditis?
Effect estimate: Adjusted HR 2.99 for MACE vs COVID+ carditis−; Adjusted HR 2.75 for all-cause mortality vs pre-pandemic carditis+ (95% CI 2.18-4.10 for MACE HR; 1.93-3.91 for mortality HR)
Absolute Event Rate: 26.99% vs 8.81%
p-value: p=<0.005
Survivors of COVID-19-associated carditis face a nearly 3-fold higher risk of long-term MACE compared to COVID-19 survivors without carditis, highlighting the need for longitudinal cardiovascular surveillance.
May warrant closer surveillance in COVID-19 carditis survivors; leaves open causal mechanisms and optimal management in prospective trials.
Background Carditis (myocarditis, pericarditis, and endocarditis) is a rare but serious complication of SARS-CoV-2 infection. While COVID-19 has been associated with heightened long-term cardiovascular risk, the long-term prognosis of survivors with clinically confirmed carditis remains poorly characterized. Methods In this observational cohort study, we analyzed electronic health records from the Montefiore Health System (2016–2024) to evaluate long-term outcomes of patients who developed carditis during COVID-19. We compared three groups: COVID+ patients with carditis within 30 days of infection ( n = 226), COVID+ patients without carditis ( n = 42,758), and pre-pandemic carditis controls ( n = 2107). Major adverse cardiovascular events (MACE) and all-cause mortality 30 days to up to 5 years post index were assessed using multivariate Cox regression adjusted for demographics, comorbidities, and social determinants. Results Over a median follow-up of 22 months, COVID+ carditis+ patients had a significantly higher risk of MACE compared to COVID+ carditis− patients (adjusted HR 2.99 [95% CI 2.18, 4.10]) and higher all-cause mortality than pre-pandemic carditis + patients (adjusted HR 2.75 [1.93, 3.91]). Among COVID+ patients, myocarditis cases exhibited the lowest left ventricular ejection fraction and highest troponin elevations during acute illness, followed by patients with endocarditis and then pericarditis. Conclusion Survivors of COVID-19-associated carditis are at higher risk of all-cause mortality than non-COVID-19 carditis patients and at higher risk of MACE than non-carditis COVID-19 patients up to 5-year follow-up. These findings highlight the need for longitudinal surveillance and tailored cardiovascular care in survivors of COVID-19-associated carditis.
No takes yet. Share an insight, caveat, or question.
Hadidchi et al. (2026) conducted an observational in Adults (≥21 years old) who developed carditis during acute COVID-19 infection compared to COVID-19 patients without carditis and pre-pandemic carditis patients (n=45,191). COVID-19-associated carditis vs. COVID-19 patients without carditis and pre-pandemic carditis patients was evaluated on Major adverse cardiovascular events (MACE) and all-cause mortality >30 days post-index date (Adjusted HR 2.99 for MACE vs COVID+ carditis−; Adjusted HR 2.75 for all-cause mortality vs pre-pandemic carditis+, 95% CI 2.18-4.10 for MACE HR; 1.93-3.91 for mortality HR, p=<0.005). COVID-19-associated carditis increased risk of MACE by nearly threefold (HR 2.99) compared to COVID-19 patients without carditis and increased all-cause mortality by 2.75-fold versus pre-pandemic carditis patients over up to 5 years follow-up.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: