Key result
A concomitant diagnosis of viral infection in patients hospitalized with myocarditis was associated with significantly higher in-hospital mortality (23.6% vs. 4.4%, adjusted OR 2.03).
Why the study?
Myocarditis is commonly caused by viruses, but the influence of different viral infections on patient outcomes was unknown.
Does a co-diagnosis of viral infection increase in-hospital mortality, length of stay, and cost in patients admitted with myocarditis?
Cohort (n=27,050)
Yes
Does a co-diagnosis of viral infection increase in-hospital mortality, length of stay, and cost in patients admitted with myocarditis?
Odds Ratio: 2.03 (95% CI 1.51–2.73)
Absolute Event Rate: 23.6% vs 4.4%
p-value: p=<0.001
In patients hospitalized with myocarditis, a co-diagnosis of viral infection is present in 25% of cases and is independently associated with a two-fold increase in in-hospital mortality, longer stays, and higher costs.
Concomitant viral infections may affect myocarditis outcomes; leaves open differential prognostic impact by virus type.
Background: The influence of different viral infections in patients with myocarditis is unknown. Myocarditis is an inflammatory disease of heart muscle that is commonly caused by viruses. The impact of different viral infections in patients with myocarditis is unknown. Methods: We conducted a retrospective cohort study using data between 2016–2020 in the National Inpatient Sample in the USA to evaluate admissions with myocarditis and concomitant viral infection. The outcomes of in-hospital mortality, length of stay (LoS), and cost, among patients hospitalized for myocarditis was evaluated. Results: A total of 27,050 hospital admissions for myocarditis were included and 6750 (25.0%) had a co-diagnosis of viral infection. Patients with myocarditis and viral infection had significantly higher mortality compared to those without viral infection (23.6% vs. 4.4%, p < 0.001). Viral infection was associated with increased in-hospital mortality (odds ratio (OR) 2.03, 95% CI 1.51 to 2.73, p < 0.001), greater median LoS (7 vs. 3 days, p < 0.001) and median hospitalization cost ($21,445 vs. $11,596, p < 0.001), compared to patients without viral infection. The rate of death was greatest for patients with a diagnosis of coronavirus disease 2019 (COVID-19), viral pneumonia and herpes zoster, respiratory syncytial virus, chronic hepatitis, and influenza which was 36.0%, 34.3%, 27.3%, 21.4%, 20.0%, and 14.5%, respectively. Conclusions: In conclusion, the diagnosis of viral infection is present in one in four patients hospitalized with myocarditis and is correlated with greater mortality, LoS, and in-hospital cost.
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Kwok et al. (2023) conducted a cohort in Myocarditis (n=27,050). Concomitant viral infection vs. No viral infection was evaluated on In-hospital mortality (OR 2.03, 95% CI 1.51 to 2.73, p=<0.001). A concomitant diagnosis of viral infection in patients hospitalized with myocarditis was associated with significantly higher in-hospital mortality (23.6% vs. 4.4%, adjusted OR 2.03).
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