Key result
Pandemic onset linked to ~11% rise in myocarditis admissions alongside increased endocarditis hospitalizations.
Why the study?
The impact of the COVID-19 pandemic on hospitalizations for cardiac infections was not well known.
Does the COVID-19 pandemic and lockdown affect the number of hospitalizations for myocarditis and endocarditis in France?
Cohort (n=11,855)
Yes
Does the COVID-19 pandemic and lockdown affect the number of hospitalizations for myocarditis and endocarditis in France?
The COVID-19 pandemic was associated with an overall increase in hospitalizations for myocarditis and endocarditis, driven by COVID-19-positive cases during the lockdown and a post-lockdown rebound in non-COVID-19 endocarditis cases.
Associated rises warrant myocarditis/endocarditis monitoring in COVID-19 patients; leaves open lockdown effects on non-COVID admissions.
BACKGROUND: The impact of the COVID-19 pandemic on hospitalization for cardiac infections is not well known. We aimed to evaluate the nationwide trends in hospital stays for myocarditis and endocarditis cases before, during and after the nationwide lockdown for the COVID-19 pandemic in France. We then aimed to describe the proportion of myocarditis and endocarditis patients with and without COVID-19 and their clinical characteristics. METHODS: Hospitalized cases of cardiac infection were extracted from the French National Discharge database, which collects the medical records of all patients discharged from all public and private hospitals in France. Age, sex, and available cardiovascular risk factors were compared between stays with and without COVID-19 during the lockdown. RESULTS: The number of myocarditis cases was 11% higher in 2020, compared to the average of the three prior years. In 2020, 439 of 3727 cases of myocarditis were associated with COVID-19. For endocarditis, there was an increase in cases by 7% in 2020 versus prior years. For endocarditis, 3% (240 of 8128 cases) of patients with endocarditis had COVID-19. For myocarditis, older age, hypertension, diabetes, obesity, and atrial fibrillation were more frequent in patients with COVID-19 than in those without. For endocarditis, only hypertension was more frequent in patients with COVID-19 than in those without. CONCLUSION: Our study reports an increase in hospitalizations for both myocarditis and endocarditis in 2020, possibly related to the COVID-19 pandemic. Interestingly, the trends differ according to the COVID-19 status. Knowledge of the factors associating myocarditis or endocarditis and COVID-19 may improve the quality and the type of monitoring for people with COVID-19, the identification of patients at risk of cardiac infections, and the treatment of COVID-19 patients.
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Pommier et al. (2022) conducted a cohort in Myocarditis and Endocarditis (n=11,855). COVID-19 pandemic and lockdown vs. Pre-pandemic period (2017-2019) and non-COVID-19 patients was evaluated on Number of hospitalizations for myocarditis and endocarditis. Hospitalizations for myocarditis increased by 11.4% and endocarditis by 7.2% in 2020 compared to the 2017-2019 average, with distinct trends based on COVID-19 status.
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