A case-control, multicentre study of consecutive patients with COVID-19 and acute (myo)pericarditis: incidence, risk factors, clinical characteristics and outcomes
Por:
Miro, O, Sabate, M, Jimenez, S, Mebazaa, A, Martinez-Nadal, G, Pinera, P, Burillo-Putze, G, Martin, A, Martin-Sanchez, FJ, Jacob, J, Alquezar-Arbe, A, Garcia-Lamberechts, EJ, Llorens, P, del Castillo, JG, Spanish Investigators Emergenc
Publicada:
1 may 2022
Ahead of Print:
1 mar 2022
Resumen:
Objective To estimate incidence, risk factors, clinical characteristics and outcomes of acute (myo)pericarditis (AMP) in patients with COVID-19. Methods Case-control, retrospective review, consecutive case inclusion performed in 62 Spanish EDs. All COVID-19 patients with AMP (cases) were compared in clinical characteristics and outcomes with COVID-19 without AMP (control group A) and non-COVID patients with AMP (control group B). We estimated unadjusted standardised incidence (SI, not adjusted by population's age/sex) of AMP in COVID-19 and non-COVID populations (per 100 000/year). Results We identified 67 AMP in COVID-19 patients (SI=56.5, OR with respect to non-COVID patients=4.43, 95% CI=3.98 to 4.94). Remarkably, COVID-19 cases presented with chest pain less frequently than non-COVID patients and had less typical ECG changes, higher NT-proBNP (N-terminal prohormone of brain natriuretic peptide), more left and right ventricular dysfunction in echocardiography and more need of inotropic/vasopressor drugs. Admission to intensive care was higher than control group A (OR=3.22, 95% CI=1.43 to 7.23), and in-hospital mortality was higher than control group B (OR=7.75, 95% CI=2.77 to 21.7). Conclusion AMP is unusual as a form of COVID-19 presentation (about 1 parts per thousand cases), but SI is more than fourfold higher than non-COVID population, and it is less symptomatic, more severe and has higher in-hospital mortality; therefore, rapid recognition, echocardiographic assessment of myopericardial inflammation/dysfunction and treatment with vasoactive drugs when needed are recommended in AMP in patients with COVID-19.
Filiaciones:
Miro, O:
Univ Barcelona, Hosp Clin, IDIBAPS, Emergency Dept, Barcelona, Spain
Sabate, M:
Hosp Clin Barcelona, Cardiol Dept, Barcelona, Spain
Jimenez, S:
Univ Barcelona, Hosp Clin, IDIBAPS, Emergency Dept, Barcelona, Spain
Mebazaa, A:
St Louis & Lariboisiere Univ Hosp, Dept Anaesthesiol & Crit Care Med, Paris, France
Martinez-Nadal, G:
Univ Barcelona, Hosp Clin, IDIBAPS, Emergency Dept, Barcelona, Spain
Pinera, P:
Hosp Reina Sofia Murcia, Emergency Dept, Murcia, Spain
Burillo-Putze, G:
Univ Europea Canarias, Hosp Univ Canarias, Emergency Dept, Tenerife, Spain
Martin, A:
Hosp Univ Severo Ochoa, Madrid, Spain
Martin-Sanchez, FJ:
Hosp Clin San Carlos, Emergency, Madrid, Spain
Jacob, J:
Hosp Univ Bellvitge, Emergency Dept, Barcelona, Spain
Alquezar-Arbe, A:
Hosp Santa Creu & Sant Pau, Emergency Dept, Barcelona, Spain
Garcia-Lamberechts, EJ:
Hosp Clin San Carlos, Emergency, Madrid, Spain
Llorens, P:
Hosp Gen Univ Alicante, Emergency Dept, Alicante, Spain
del Castillo, JG:
Hosp Clin San Carlos, Emergency, Madrid, Spain
Bronze, Green Published
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