A case-control, multicentre study of consecutive patients with COVID-19 and acute (myo)pericarditis: incidence, risk factors, clinical characteristics and outcomes.
Por:
Mirò Ò, Sabaté M, Jiménez S, Mebazaa A, Martínez-Nadal G, Piñera P, Burillo-Putze G, Martín A, Martín-Sánchez FJ, Jacob J, Alquézar-Arbé A, García-Lamberechts EJ, Llorens P, González Del Castillo J, Spanish Investigators on Emergency Situations TeAm (SIESTA) network and SIESTA network
Publicada:
1 may 2022
Ahead of Print:
18 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‰ 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:
Mirò Ò:
Emergency Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
Sabaté M:
Cardiology Department, Hospital Clínic, Barcelona, Spain
Mebazaa A:
Department of Anaesthesiology and Critical Care Medicine, Saint Louis and Lariboisière University Hospitals, Paris, France
Piñera P:
Emergency Department, Hospital Reina Sofia de Murcia, Murcia, Spain
Burillo-Putze G:
Emergency Department, Hospital Universitario de Canarias, Universidad Europea de Canarias, Tenerife, Spain
Martín A:
Hospital Universitario Severo Ochoa, Leganes, Madrid, Spain
Martín-Sánchez FJ:
Emergency, Hospital Clinico San Carlos, Madrid, Spain
Jacob J:
Emergency Department, Hospital Universitario de Bellvitge, Barcelona, Spain
Alquézar-Arbé A:
Emergency Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
García-Lamberechts EJ:
Emergency, Hospital Clinico San Carlos, Madrid, Spain
:
Emergency Department, Hospital General Universitario de Alicante, Alicante, Spain
González Del Castillo J:
Emergency, Hospital Clinico San Carlos, Madrid, Spain
Bronze, Green Published
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