• Emerg Med J · May 2022

    Multicenter Study

    A case-control, multicentre study of consecutive patients with COVID-19 and acute (myo)pericarditis: incidence, risk factors, clinical characteristics and outcomes.

    • Òscar Mirò, Manel Sabaté, Sònia Jiménez, Alexandre Mebazaa, Gemma Martínez-Nadal, Pascual Piñera, Guillermo Burillo-Putze, Alfonso Martín, Francisco Javier Martín-Sánchez, Javier Jacob, Aitor Alquézar-Arbé, Eric Jorge García-Lamberechts, Pere Llorens, Juan González Del Castillo, Spanish Investigators on Emergency Situations TeAm (SIESTA) network, and SIESTA network.
    • Emergency Department, Hospital Clínic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain omiro@clinic.cat.
    • Emerg Med J. 2022 May 1; 39 (5): 402410402-410.

    ObjectiveTo estimate incidence, risk factors, clinical characteristics and outcomes of acute (myo)pericarditis (AMP) in patients with COVID-19.MethodsCase-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).ResultsWe 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).ConclusionAMP 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.© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.

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