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Background <p>Carditis (myocarditis, pericarditis, and endocarditis) is a rare but serious complication of SARS-CoV-2 infection. While COVID-19 has been associated with heightened long-term cardiovascular risk, the long-term prognosis of survivors with clinically confirmed carditis remains poorly characterized.</p> Methods <p>In this observational cohort study, we analyzed electronic health records from the Montefiore Health System (2016–2024) to evaluate long-term outcomes of patients who developed carditis during COVID-19. We compared three groups: COVID+ patients with carditis within 30&#xa0;days of infection (<i>n</i> = 226), COVID+ patients without carditis (<i>n</i> = 42,758), and pre-pandemic carditis controls (<i>n</i> = 2107). Major adverse cardiovascular events (MACE) and all-cause mortality 30&#xa0;days to up to 5&#xa0;years post index were assessed using multivariate Cox regression adjusted for demographics, comorbidities, and social determinants.</p> Results <p>Over a median follow-up of 22&#xa0;months, COVID+ &#xa0;carditis+&#xa0; patients had a significantly higher risk of MACE compared to COVID+&#xa0; carditis−&#xa0;patients (adjusted HR 2.99 [95% CI 2.18, 4.10]) and higher all-cause mortality than pre-pandemic carditis + patients (adjusted HR 2.75 [1.93, 3.91]). Among COVID+&#xa0; patients, myocarditis cases exhibited the lowest left ventricular ejection fraction and highest troponin elevations during acute illness, followed by patients with endocarditis and then pericarditis.</p> Conclusion <p>Survivors of COVID-19-associated carditis are at higher risk of all-cause mortality than non-COVID-19 carditis patients and at higher risk of MACE than non-carditis COVID-19 patients up to 5-year follow-up. These findings highlight the need for longitudinal surveillance and tailored cardiovascular care in survivors of COVID-19-associated carditis.</p> Graphical Abstract <p></p>

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Five-year cardiovascular outcomes following COVID-19-associated carditis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月18日

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  • Roham Hadidchi,
  • Ekram Ali,
  • Wayne Shih,
  • William Zhao,
  • Siddharth Ragupathi,
  • Joseph Bisulca,
  • Trang Le,
  • Sonya Henry,
  • Tim Q. Duong

摘要

Background

Carditis (myocarditis, pericarditis, and endocarditis) is a rare but serious complication of SARS-CoV-2 infection. While COVID-19 has been associated with heightened long-term cardiovascular risk, the long-term prognosis of survivors with clinically confirmed carditis remains poorly characterized.

Methods

In this observational cohort study, we analyzed electronic health records from the Montefiore Health System (2016–2024) to evaluate long-term outcomes of patients who developed carditis during COVID-19. We compared three groups: COVID+ patients with carditis within 30 days of infection (n = 226), COVID+ patients without carditis (n = 42,758), and pre-pandemic carditis controls (n = 2107). Major adverse cardiovascular events (MACE) and all-cause mortality 30 days to up to 5 years post index were assessed using multivariate Cox regression adjusted for demographics, comorbidities, and social determinants.

Results

Over a median follow-up of 22 months, COVID+  carditis+  patients had a significantly higher risk of MACE compared to COVID+  carditis− patients (adjusted HR 2.99 [95% CI 2.18, 4.10]) and higher all-cause mortality than pre-pandemic carditis + patients (adjusted HR 2.75 [1.93, 3.91]). Among COVID+  patients, myocarditis cases exhibited the lowest left ventricular ejection fraction and highest troponin elevations during acute illness, followed by patients with endocarditis and then pericarditis.

Conclusion

Survivors of COVID-19-associated carditis are at higher risk of all-cause mortality than non-COVID-19 carditis patients and at higher risk of MACE than non-carditis COVID-19 patients up to 5-year follow-up. These findings highlight the need for longitudinal surveillance and tailored cardiovascular care in survivors of COVID-19-associated carditis.

Graphical Abstract