Catheter Cardiovasc Interv. 2026 May 17. doi: 10.1002/ccd.70659. Online ahead of print.
ABSTRACT
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic introduced a surge in cardiovascular complications, with myocarditis emerging as a concern due to both direct viral effects and rare vaccine-associated events.
AIMS: This analysis examines the incidence and outcomes of myocarditis in patients across a large healthcare system in the Washington, DC Metropolitan Area, focusing on periods before, during, and after the COVID-19 pandemic.
METHODS: A retrospective cohort study was conducted using electronic health records from the MedStar Health System (2017-2024). Myocarditis cases were identified using ICD-10 codes, with cases stratified by pre- (2017-2019), peri- (2020-2022), and post-COVID-19 (2023-2024) pandemic periods, as well as by association with COVID-19 infection and/or vaccination. The overall incidence and inpatient mortality of myocarditis were compared over these eras.
RESULTS: This study included 778 myocarditis patients admitted between January 2017 and December 2024, categorized into pre-COVID-19 (n = 207), peri-COVID-19 (n = 370), and post-COVID-19 (n = 201) periods. Total myocarditis incidence surged during the peri-pandemic period, peaking in 2022, and declined in 2023-2024. In the post-pandemic period, total myocarditis remained elevated and higher than in the pre-pandemic era. During the pandemic and post-pandemic periods, myocarditis patients were older, included a higher proportion of African American individuals, and had a greater burden of cardiometabolic comorbidities, compared to pre-pandemic myocarditis hospitalizations.
CONCLUSION: This study demonstrates a marked increase in myocarditis cases during the COVID-19 pandemic, driven initially by a surge in COVID-19-related myocarditis. Notably, total myocarditis cases remained elevated in the post-pandemic period compared to pre-pandemic levels. These findings, particularly the increased post-pandemic myocarditis patients, warrant further investigation into underlying risk factors and long-term outcomes.
PMID:42144794 | DOI:10.1002/ccd.70659