(160) Trends of Myocarditis/Pericarditis following SARS-CoV-2 Infection: A Real-World Analysis of a Large US Commercial Claims Database Enriched with Ambulatory EMR Data

Publication Number: 821

Background: Limited but growing evidence supports an association between SARS-CoV-2 infection and myocarditis/pericarditis (M/P), a rare but serious cardiac complication. Few studies have assessed trends of SARS-CoV-2 associated M/P in COVID-19 positive and negative individuals.

Objectives: To ascertain trends in SARS-CoV-2–associated M/P using commercial claims database enriched with electronic medical record (EMR) data in the United States (US).

Methods: Within IQVIA’s PharMetrics® Plus commercial health plan claims database linked to IQVIA’s Ambulatory EMR-US data (AEMR-US), which is mapped to the Observational Medical Outcomes Partnership (OMOP) Common Data Model, a group of patients aged 18- 64 years with a positive/negative COVID-19 test between 2020-2022 were identified. Patients were excluded if they had less than 180 days observable data; a prior history of M/P; myocardial infarction; cardiac surgery, or a COVID-19 diagnosis prior to the index date. The index date was defined as the day of the first positive/negative COVID-19 diagnosis. The primary outcome was a first encounter diagnosis of M/P within 100 days following the index date (COVID-19 diagnosis). The secondary outcome was a first encounter diagnosis of M/P within 100 days following the index date (negative COVID-19 diagnosis). We stratified patients by gender and age to investigate the impact on effect modification.

Results: Between 2020-2022, we identified 7,336,778 patients with a positive and 387,633 patients with a negative COVID-19 test, respectively. In the COVID-19 positive test cohort, 55% of patients were females (n=4,062,601) compared to 61% (n=235,248) in the COVID-19 negative test cohort. In the COVID-19 positive exposure cohort, there were 4,017 cases (0.05%) of M/P (54% males vs 46% females) compared to 107 cases (0.03%) in the COVID-19 negative test cohort (44% males vs 56% females). In age stratified analyses, males with COVID-19 aged 36-64 years had 69 cases of M/P per 100,000 patients compared to 29 cases per 100,000 patients in those without COVID-19.

Conclusions: Overall, the incidence of M/P was low among both COVID-19 positive and negative patients. However, older males aged 36-64 with COVID-19 had a higher rate of M/P compared to similarly aged males without COVID-19. To minimize the impact of COVID-19, evidence-based strategies are required to prevent SARS-CoV-2 infection and associated serious complications.