Impact of Sars COV2 infection on acute myocarditis: Observational study of patients admitted from 2019 to 2021

INTRODUCTION: Cases of acute myocarditis related to SARS COV2 infection and/or vaccines have been described but characteristics and complications require further research. OBJECTIVE: To analyze myocarditis directly related to SARS COV 2 infection and to compare with myocarditis before Covid as well as myocarditis related to Covid vaccines. METHOD: Using PMSI coding, we included all patients hospitalized for myocarditis in 2 centers between 2019 and 2021 and analyzed clinical characteristics and early outcomes. The diagnosis had to be established by ESC guidelines including cardiac MRI and/or endomyocardial biopsy. We compared myocarditis related to COVID-19 infection with 2019 myocarditis (before Covid) and to Covid vaccination. Patients developing cardiogenic shock were also analyzed. RESULTS: Acute myocarditis related to COVID were diagnosed in 21 in-patients who had Covid symptoms several weeks before admission (post-Covid) or during hospitalization (per-Covid). Characteristics are shown in Table 1. Cardiogenic shock was observed in 7 patients and was associated with higher inflammation and more frequent myocardial necrosis in biopsy. As compared with 54 patients hospitalized in 2019 (before COVID), SarsCov2 related were more severe with more inflammation but had similar outcome. CONCLUSION: Acute myocarditis related to COVID-19 are associated with severe systemic inflammation and relatively frequent heart failure as compared to others myocarditis, but all patients recovered whatever the cause in this cohort.