Key result
Acute pericarditis in hospitalized COVID-19 linked to ~2-fold higher in-hospital mortality.
Why the study?
Acute pericarditis is considered a cardiovascular complication in COVID-19, but its incidence, associated complications, and clinical impact on hospitalized patients needed assessment.
Is acute pericarditis associated with worse in-hospital outcomes in hospitalized patients with COVID-19?
Cohort (n=211,619)
Yes
Is acute pericarditis associated with worse in-hospital outcomes in hospitalized patients with COVID-19?
Acute pericarditis is a rare but severe complication in hospitalized COVID-19 patients, associated with significantly increased in-hospital mortality and cardiovascular complications.
Flags higher-risk COVID-19 patients for monitoring; observational data leave open causality and need for targeted trials.
Background Acute pericarditis (AP) is considered a cardiovascular complication in patients with COVID‐19. We aimed to ass‐ess the incidence, associated complications, and clinical impact of AP on hospitalized patients with COVID‐19. Methods and Results In this retrospective cohort study, International Classification of Diseases, Tenthth Revision, Clinical Modification ( ICD‐10 ) codes were used to identify patients with COVID‐19 with or without AP in the National Inpatient Sample 2020 database. We compared outcomes between AP and non‐AP groups before and after propensity‐score matching for patient and hospital demographics and relevant comorbidities. A total of 211 619 patients with a primary diagnosis of COVID‐19 were identified, including 983 (0.46%) patients who had a secondary diagnosis of AP. Before matching, patients with COVID‐19 with AP were younger (59.93±19.24 years old versus 64.29±16.82 years old) and more likely to have anemia (40.5% versus 19.9%), cancer (6.7% versus 3.6%), and chronic kidney disease (29.3% versus 19.6%) (all P <0.05). After matching, patients with COVID‐19 with AP (n=980), when compared with the matched non‐AP group (n=2936), had higher rates of mortality (21.3% versus 11.1%, P <0.001), cardiac arrest (5.0% versus 2.6%, P <0.001), cardiogenic shock (4.2% versus 0.5%, P <0.001), ventricular arrhythmia (4.7% versus 1.9%, P <0.001), acute kidney injury (38.3% versus 28.9%, P <0.001), acute congestive heart failure (14.3% versus 4.8%, P <0.001), and longer length of stay (7.00±10.00 days versus 5.00±7.00 days, P <0.001) and higher total charges ($75066.5±$130831.3 versus $44824.0±$63660.5, P <0.001). Conclusions In hospitalized patients with COVID‐19, AP is a rare but severe in‐hospital complication and is associated with worse in‐hospital outcomes.
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Li et al. (2023) conducted a cohort in COVID-19 with or without Acute Pericarditis (n=211,619). Acute pericarditis vs. COVID-19 without acute pericarditis was evaluated on In-hospital mortality (matched cohort) (p=<0.001). Hospitalized patients with COVID-19 who developed acute pericarditis had a significantly higher in-hospital mortality rate (21.3% vs 11.1%) compared to matched patients without acute pericarditis.
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