Fondazione Toscana G.Monasterio, Pisa.
Department of Clinical and experimental medicine, University of Messina.
J Cardiovasc Med (Hagerstown). 2022 Jul 1;23(7):447-453. doi: 10.2459/JCM.0000000000001330. Epub 2022 Jun 23.
Myocarditis and pericarditis have been proposed to account for a proportion of cardiac injury during SARS-CoV-2 infection. The impact of COVID-19 the pandemic on the incidence of this acute inflammatory cardiac disease was not systematically evaluated.
To examine the incidence and prevalence of inflammatory heart disorders prior to and during the COVID-19 pandemic.
We compared the incidence and prevalence of acute inflammatory heart diseases (myocarditis, pericarditis) in the provinces of Pisa, Lucca and Livorno in two time intervals: prior to (PRECOVID, from 1 June 2018 to 31 May 2019) and during the COVID-19 pandemic (COVID, from 1 June 2020 to May 2021).
Overall 259 cases of inflammatory heart disease (myocarditis and/or pericarditis) occurred in the areas of interest. The annual incidence was of 11.3 cases per 100 000 inhabitants. Particularly, 138 cases occurred in the pre-COVID, and 121 in the COVID period. The annual incidence of inflammatory heart disease was not significantly different (12.1/100 000 in PRECOVID vs 10.3/100 000 in COVID, P = 0.22). The annual incidence of myocarditis was significantly higher in PRECOVID than in COVID, respectively 8.1/100 000/year vs. 5.9/100 000/year (P = 0.047) consisting of a net reduction of 27% of cases. Particularly the incidence of myocarditis was significantly lower in COVID than in PRECOVID in the class of age 18-24
Despite a possible etiologic role of SARS-CoV-2 and an expectable increased incidence of myocarditis and pericarditis, data of this preliminary study, with a geographically limited sample size, suggest a decrease in acute myocarditis and a stable incidence of pericarditis and of myopericarditis/perimyocarditis.
心肌炎和心包炎被认为是 SARS-CoV-2 感染导致的一部分心脏损伤。COVID-19 大流行对这种急性炎症性心脏病的发病率的影响尚未系统评估。
在 COVID-19 大流行之前和期间，检查炎症性心脏病的发病率和患病率。
我们比较了比萨、卢卡和里窝那三省在两个时间段内急性炎症性心脏病（心肌炎、心包炎）的发病率和患病率：大流行前（PRECOVID，2018 年 6 月 1 日至 2019 年 5 月 31 日）和 COVID-19 期间（COVID，2020 年 6 月 1 日至 2021 年 5 月）。
在所关注的地区共有 259 例炎症性心脏病（心肌炎和/或心包炎）。年发病率为每 100000 人 11.3 例。其中，138 例发生在 PRECOVID 期间，121 例发生在 COVID 期间。炎症性心脏病的年发病率无显著差异（PRECOVID 为 12.1/100000，COVID 为 10.3/100000，P=0.22）。PRECOVID 年心肌炎发病率明显高于 COVID，分别为 8.1/100000/年和 5.9/100000/年（P=0.047），病例减少 27%。特别是在 18-24 岁年龄组中，COVID 年心肌炎的发病率明显低于 PRECOVID。尽管如此，COVID 期的心肌炎仍有更多的壁运动异常和更大的 LGE 范围。心包炎的年发病率无显著差异（分别为 4.03/100000 和 4.47/100000，P=0.61）。
尽管 SARS-CoV-2 可能具有病因作用，并且预期心肌炎和心包炎的发病率会增加，但这项初步研究的数据（样本量有限，地理位置有限）表明，急性心肌炎的发病率下降，心包炎和心肌心包炎/心肌周炎的发病率稳定。
