Dataset Information

Association Between Myocarditis and Mortality in COVID-19 Patients in a Large Registry.

ABSTRACT:

Objective

To present a large registry data assessing the association between myocarditis and mortality in patients with severe acute respiratory syndrome coronavirus 2 infection.

Patients and methods

The researchers identified adult patients aged 18 to 90 years of age with coronavirus disease 2019 (COVID-19) diagnosis in the TriNetX (COVID-19 research network) database between January 20, 2020, and December 9, 2020. These patients were then divided into groups of those who had a positive myocarditis diagnosis and those who did not. The researchers compared all-cause mortality between propensity-matched pairs of patients in both groups.

Results

A total of 259,352 patients with COVID-19 diagnosis were included in the study. Of those patients, 383 (0.2%) had myocarditis diagnosis, whereas 258,969 (99.8%) did not have myocarditis diagnosis during their hospital stay. Patients were predominantly male in the myocarditis group (59.0% vs 45.0%, P<0.001). As to the propensity-matched cohorts, 383 of 383 were matched, and the all-cause mortality was 13.4 % vs 4.2% (P<0.001) at 30 days. A Kaplan-Meier survival analysis was also statistically significant (P<0.001) at 30 days.

Conclusion

In a large multinational database of COVID-19 patients, we observed an association between myocarditis diagnosis and increased mortality. Further prospective studies are recommended to further assess myocarditis outcomes in COVID-19 patients and treatment options.

SUBMITTER: Annie FH

PROVIDER: S-EPMC8710397 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundQingfei Paidu Tang (QPT), a formula of traditional Chinese medicine, which was suggested to be able to ease symptoms in patients with Coronavirus Disease 2019 (COVID-19), has been recommended by clinical guidelines and widely used to treat COVID-19 in China. However, whether it decreases mortality remains unknown.PurposeWe aimed to explore the association between QPT use and in-hospital mortality among patients hospitalized for COVID-19.Study designA retrospective study based on a real-world database was conducted.MethodsWe identified patients consecutively hospitalized with COVID-19 in 15 hospitals from a national retrospective registry in China, from January through May 2020. Data on patients' characteristics, treatments, and outcomes were extracted from the electronic medical records. The association of QPT use with COVID-19 related mortality was evaluated using Cox proportional hazards models based on propensity score analysis.ResultsOf the 8939 patients included, 28.7% received QPT. The COVID-19 related mortality was 1.2% (95% confidence interval [CI] 0.8% to 1.7%) among the patients receiving QPT and 4.8% (95% CI 4.3% to 5.3%) among those not receiving QPT. After adjustment for patient characteristics and concomitant treatments, QPT use was associated with a relative reduction of 50% in-hospital COVID-19 related mortality (hazard ratio, 0.50; 95% CI, 0.37 to 0.66 p < 0.001). This association was consistent across subgroups by sex and age. Meanwhile, the incidences of acute liver injury (8.9% [95% CI, 7.8% to 10.1%] vs. 9.9% [95% CI, 9.2% to 10.7%]; odds ratio, 0.96 [95% CI, 0.81% to 1.14%], p = 0.658) and acute kidney injury (1.6% [95% CI, 1.2% to 2.2%] vs. 3.0% [95% CI, 2.6% to 3.5%]; odds ratio, 0.85 [95% CI, 0.62 to 1.17], p = 0.318) were comparable between patients receiving QPT and those not receiving QPT. The major study limitations included that the study was an observational study based on real-world data rather than a randomized control trial, and the quality of data could be affected by the accuracy and completeness of medical records.ConclusionsQPT was associated with a substantially lower risk of in-hospital mortality, without extra risk of acute liver injury or acute kidney injury among patients hospitalized with COVID-19.