Prevalence and Outcomes of Myocarditis in Dengue-Infected Patients Admitted to a Tertiary Care Hospital of Low-Middle Income Country

BACKGROUND: Myocarditis is a challenging diagnosis due to the heterogeneity of clinical presentations. Myocarditis can present with a mildly raised cardiac enzyme to severe myocarditis leading to congestive heart failure, arrhythmias, cardiogenic shock, and death. It is a predictor of morbidity and...

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Detalles Bibliográficos
Autores principales: Baqi, Abdul, ur Rehman, Fazal, Memon, Pirbhat Shams, Omair, Syed Furrukh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Ubiquity Press 2022
Materias:
Original Research
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9231571/
https://www.ncbi.nlm.nih.gov/pubmed/35837358
http://dx.doi.org/10.5334/gh.1129
Descripción
Sumario:BACKGROUND: Myocarditis is a challenging diagnosis due to the heterogeneity of clinical presentations. Myocarditis can present with a mildly raised cardiac enzyme to severe myocarditis leading to congestive heart failure, arrhythmias, cardiogenic shock, and death. It is a predictor of morbidity and mortality in dengue-infected patients. The exact prevalence of dengue myocarditis and its outcomes are unknown in Pakistan. OBJECTIVES: We aim to study the prevalence and association of myocarditis with the length of stay in the hospital and mortality of dengue-infected patients. METHODS: A retrospective observational study done at a tertiary care hospital. We reviewed hospital record files of 1008 consecutive patients with dengue viral infection admitted from November 2018 to November 2019. RESULTS: Out of 1008 dengue-infected patients, 55.4% of patients were older than 35 years and 68.4% were males. Hypertension (HTN) was the most common comorbid condition. The prevalence of myocarditis in hospitalized dengue-infected patients was 4.2%. All (100%) of dengue myocarditis patients had raised cardiac troponin I (cTn-I), 59.5% of patients had at least one electrocardiography (ECG) change, and 24% had reduced ejection fraction (EF) (defined as EF < 55%). On multivariable analysis, patients with raised cTn-I levels (adjusted odds ratios = 5.29; [95% confidence interval (CI): 2.16–12.96]) and abnormal echocardiography (ECHO) [aOR = 4.38; 95% CI: 1.26–15.27)] had a prolonged hospital stay (>3 days). Raised cTn-I levels (aOR = 8.2; [95% CI: 1.83–36.84]) was significantly associated with in-hospital mortality. CONCLUSIONS: Raised cTn-I is the predictor of length of stay and in-hospital mortality in dengue-infected patients. Atrial fibrillation, diabetes mellitus, hypertension, low serum bicarbonate, high serum creatinine, and any abnormality on echocardiography were associated with adverse outcomes in dengue-infected patients.

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