Heart inflammation rare among people hospitalized with COVID-19, study
finds
Date:
April 11, 2022
Source:
American Heart Association
Summary:
A new study found that 54 out of nearly 57,000 adults (a rate
of 2.4 of every 1,000) hospitalized due to COVID-19 infection
developed acute myocarditis, an inflammation of the heart muscle
often caused by viral infections. The study data was from the first
14 months of the COVID-19 pandemic, before the COVID-19 vaccines
were broadly available.
FULL STORY ========================================================================== Acute myocarditis, inflammation of the heart muscle typically triggered by
a virus, occurred in about two out of every 1,000 people hospitalized with COVID- 19, and was associated with more severe illness and complications
in people with COVID-19, especially among people who also had pneumonia, according to new research published today in the American Heart
Association's flagship, peer- reviewed journal Circulation.
========================================================================== Myocarditis is a rare but serious condition that causes inflammation
of the heart muscle. It can weaken the heart and its electrical system,
and it can make it difficult for the heart to pump blood. An episode of myocarditis may resolve on its own or with treatment or may result in long-lasting damage.
"While COVID-19 is a virus that predominantly leads to acute respiratory illness, there has been a small group of individuals who also experience cardiac complications," said Enrico Ammirati, M.D., Ph.D., co-lead
author of the study and a cardiologist at De Gasperis Cardio Center
and Transplant Center at Niguarda Hospital in Milan, Italy. "A small
study previously indicated acute myocarditis is a rare occurrence in
people infected with COVID-19. Our analysis of international data offers
better insight to the occurrence of acute myocarditis during COVID-19 hospitalization, particularly before the COVID-19 vaccines were widely available." The international study examined health data for almost
57,000 people who were hospitalized with COVID-19 from February 2020
until April 2021, and who received care at 23 hospitals across the United States and Europe.
Within the large study group, a total of 54 people hospitalized with
COVID-19 were identified as having definite or probable acute myocarditis, based upon results of heart muscle biopsy and/or magnetic resonance
imaging. Most of the people in this study were non-Hispanic white adults (76.5%), with an average age of 38 years, and more than half were male
(61%). All had confirmed cases of COVID-19 infection based upon standard laboratory testing, and none had received a COVID-19 vaccination prior
to developing myocarditis.
The study analysis found:
* An estimated 2.4 per 1,000 people hospitalized for COVID-19
had acute
myocarditis.
* Acute myocarditis occurred more frequently in people who did
not have
pneumonia (57.4%) and was complicated by abnormal or unstable
blood flow (hemodynamic instability) in 32% of cases.
* The people found to have both COVID-19-related acute myocarditis and
pneumonia had a mortality rate of 15.1%, compared to no deaths
during hospitalization in the people who did not have pneumonia. The
people with pneumonia were older than those without pneumonia
(average age of 45 years vs. 30 years, respectively).
* One in five of the people with confirmed myocarditis (20.4%),
most of
whom also had pneumonia, needed mechanical support for circulation
or died while in the hospital.
* Twenty-one individuals (38.9%) had fulminant (severe and/or
sudden) acute
myocarditis, and due to shock, they needed immediate medication
support and mechanical circulatory support.
The authors note the potential rate of COVID-19 related myocarditis may be between 1.2-5.7 per 1,000 people hospitalized for COVID-19. Some people
were identified with possible myocarditis based on preliminary testing,
yet they were not included in the final analysis because they did not
meet all of the study's protocols.
"This analysis indicates that, although rare, hospitalized patients
with acute myocarditis associated with COVID-19 infection have a much
greater need for intensive care unit admission, in up to 70.5% of the
cases, despite the average age of the individuals in the study being
much younger than expected at 38 years old," said co-lead study author
Marco Metra, M.D., a cardiology professor at the Institute of Cardiology
and in the department of medical and surgical specialties, radiological sciences and public health at the University of Brescia in Brescia, Italy.
The study has several limitations. Because the analysis was retrospective, there may have been some potential selection bias. Additionally, 43
individuals with possible acute myocarditis were excluded due to a
lack of imaging or biopsy information. People older than 70 years of
age were also not included because of a higher chance of age-related
cardiac issues visible on magnetic resonance imaging. Some people were
not screened for other viruses or immunological causes of myocarditis,
so there may have been other contributing factors. Further, in some of
the hospitals that were heavily hit early in the pandemic, some people
with acute myocarditis may have been missed.
Co-authors are Laura Lupi, M.D.; Matteo Palazzini, M.D.; Nicholas
S. Hendren, M.D.; Justin L. Grodin, M.D., M.P.H.; Carlo V. Cannistraci,
Eng., Ph.D.; Matthieu Schmidt, M.D.; Guillaume Hekimian, M.D.; Giovanni Peretto, M.D.; Thomas Bochaton, M.D.; Ahmad Hayek, M.D.; Nicolas Piriou,
M.D.; Sergio Leonardi, M.D.; Stefania Guida, M.D.; Annalisa Turco, M.D.;
Simone Sala, M.D.; Aitor Uribarri, M.D.; Caroline M. Van de Heyning,
M.D., Ph.D.; Massimo Mapelli, M.D.; Jeness Campodonico, M.D.; Patrizia Pedrotti, M.D.; Maria Isabel Barrionuevo Sa'nchez, M.D.; Albert Ariza
Sole, M.D.; Marco Marini, M.D.; Maria Vittoria Matassini, M.D.; Mickael Vourc'h, M.D.; Antonio Cannata`, M.D.; Daniel I. Bromage, M.D.; Daniele Briguglia, M.D.; Jorge Salamanca, M.D.; Pablo Diez- Villanueva, M.D.,
Ph.D.; Jukka Lehtonen, M.D.; Florent Huang, M.D.; Ste'phanie Russel, M.D.; Francesco Soriano, M.D.; Fabrizio Turrini, M.D.; Manlio Cipriani, M.D.;
Manuela Bramerio, M.D.; Mattia Di Pasquale, M.D.; Aurelia Grosu, M.D.;
Michele Senni, M.D.; Davide Farina, M.D.; Piergiuseppe Agostoni, M.D.;
Stefania Rizzo, M.D., Ph.D.; Monica De Gaspari, M.D.; Francesca Marzo,
M.D.; Jason M.
Duran, M.D., Ph.D.; Eric D. Adler, M.D.; Cristina Giannattasio, M.D.,
Ph.D.; Cristina Basso, M.D., Ph.D.; Theresa McDonagh, M.D.; Mathieu
Kerneis, M.D.; Alain Combes, M.D.; Paolo G. Camici, M.D.; and James
A. de Lemos, M.D. Authors' disclosures are listed in the manuscript.
This study was funded by an Italian Ministry Grant and the Registry for
Cardio- Cerebro-Vascular Pathology in Veneto Region, Italy.
========================================================================== Story Source: Materials provided by American_Heart_Association. Note:
Content may be edited for style and length.
========================================================================== Journal Reference:
1. Enrico Ammirati, Laura Lupi, Matteo Palazzini, Nicholas S. Hendren,
Justin L. Grodin, Carlo V. Cannistraci, Matthieu Schmidt, Guillaume
Hekimian, Giovanni Peretto, Thomas Bochaton, Ahmad Hayek, Nicolas
Piriou, Sergio Leonardi, Stefania Guida, Annalisa Turco, Simone
Sala, Aitor Uribarri, Caroline M. Van de Heyning, Massimo Mapelli,
Jeness Campodonico, Patrizia Pedrotti, Maria Isabel Barrionuevo
Sa'nchez, Albert Ariza Sole, Marco Marini, Maria Vittoria
Matassini, Mickael Vourc'h, Antonio Cannata`, Daniel I. Bromage,
Daniele Briguglia, Jorge Salamanca, Pablo Diez-Villanueva, Jukka
Lehtonen, Florent Huang, Ste'phanie Russel, Francesco Soriano,
Fabrizio Turrini, Manlio Cipriani, Manuela Bramerio, Mattia Di
Pasquale, Aurelia Grosu, Michele Senni, Davide Farina, Piergiuseppe
Agostoni, Stefania Rizzo, Monica De Gaspari, Francesca Marzo, Jason
M. Duran, Eric D. Adler, Cristina Giannattasio, Cristina Basso,
Theresa McDonagh, Mathieu Kerneis, Alain Combes, Paolo G. Camici,
James A. de Lemos, Marco Metra. Prevalence, Characteristics, and
Outcomes of COVID-19-Associated Acute Myocarditis. Circulation,
April 11, 2022; DOI: 10.1161/ClRCULATIONAHA.121.056817 ==========================================================================
Link to news story:
https://www.sciencedaily.com/releases/2022/04/220411142409.htm
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