ArticleClinical research in cardiology : official journal of the German Cardiac Society2026
Five-year cardiovascular outcomes following COVID-19-associated carditis.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCarditis (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.
methodsIn 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.
resultsOver 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.
conclusionSurvivors 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.
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