Impact of the COVID-19 pandemic on hospitalizations for endocarditis, myocarditis, and pericarditis using an interrupted time series analysis of the United States National Inpatient Sample 2018 to 2020
Creators: name: Browning, Steven
name: Marji, Meera
name: Kucharska-Newton, Anna
name: Leung, Steve W.
Publisher: name: The University of North Carolina at Chapel Hill University Libraries
Year: 2025

description: <p>Background The mitigation measures implemented in March 2020 in response to the COVID-19 pandemic resulted in an overall abrupt decline in hospitalizations. Endocarditis, myocarditis, and pericarditis are acute conditions that can lead to substantial morbidity and mortality when treatment is delayed. The effect of the COVID-19 pandemic on hospitalizations for those conditions has not been fully explored.ObjectiveTo compare national trends of endocarditis, myocarditis, and pericarditis hospitalizations in the US before and during the COVID-19 pandemic. Methods The ICD-10-CM codes from the National Inpatient Sample (NIS) data were used to identify hospitalizations for endocarditis, myocarditis, and pericarditis occurring from 2018 through 2020 among individuals 18 years of age or older. Using an interrupted time series analysis design, we compared the number of hospitalizations for those conditions during the pandemic period (March 2020 to December 2020) to the period before the COVID-19 pandemic (January 2018 to February 2020). All reported numbers are weighted and represent national estimates. Results Among 76,762,573 all-cause hospitalizations occurring nationally from January 2018 to February 2020, 193,930 were for endocarditis, 21,685 for myocarditis, and 49,650 for pericarditis. During the pandemic period (March 2020 to December 2020), of the total 26,422,315 hospitalizations, 72,030 were for endocarditis, 13,480 for myocarditis, and 17,110 for pericarditis. Hospital length of stay significantly increased for all three conditions during the pandemic compared to the pre-pandemic period: 13.4 versus 12.8 days for endocarditis (p&thinsp;&le;&thinsp;0.01), 8.7 days versus 6 days for myocarditis (p&thinsp;&le;&thinsp;0.01), and 6.7 versus 6.1 days for pericarditis (p&thinsp;&le;&thinsp;0.01). In-hospital mortality during the pandemic period for endocarditis was 11.1% versus 9.1% pre-pandemic (p&thinsp;&le;&thinsp;0.01), 16.8% versus 3.9% pre-pandemic (p&thinsp;&le;&thinsp;0.01) for myocarditis, and 4% versus 2.8% pre-pandemic for pericarditis (p&thinsp;&le;&thinsp;0.01). Interrupted time series analysis showed an immediate decrease in monthly admissions for endocarditis and pericarditis soon after the states&rsquo; COVID-19 shutdowns. However, myocarditis hospitalizations almost doubled from 880 in February 2020 to 1605 and 1740 in March and April 2020, respectively. Conclusions We observed an immediate increase in monthly hospitalizations for myocarditis and an immediate decrease in hospitalizations for endocarditis and pericarditis following the national COVID-19 lockdown compared to the pre-pandemic period. Length of stay and in-hospital mortality significantly increased during the pandemic period for all three health conditions.</p>