{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T21:15:12Z","timestamp":1793222112648,"version":"4.5.0"},"reference-count":50,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2022,4,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Acute myocarditis (AM) is thought to be a rare cardiovascular complication of COVID-19, although minimal data are available beyond case reports. We aim to report the prevalence, baseline characteristics, in-hospital management, and outcomes for patients with COVID-19\u2013associated AM on the basis of a retrospective cohort from 23 hospitals in the United States and Europe.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 112 patients with suspected AM from 56\u2009963 hospitalized patients with COVID-19 were evaluated between February 1, 2020, and April 30, 2021. Inclusion criteria were hospitalization for COVID-19 and a diagnosis of AM on the basis of endomyocardial biopsy or increased troponin level plus typical signs of AM on cardiac magnetic resonance imaging. We identified 97 patients with possible AM, and among them, 54 patients with definite\/probable AM supported by endomyocardial biopsy in 17 (31.5%) patients or magnetic resonance imaging in 50 (92.6%). We analyzed patient characteristics, treatments, and outcomes among all COVID-19\u2013associated AM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      AM prevalence among hospitalized patients with COVID-19 was 2.4 per 1000 hospitalizations considering definite\/probable and 4.1 per 1000 considering also possible AM. The median age of definite\/probable cases was 38 years, and 38.9% were female. On admission, chest pain and dyspnea were the most frequent symptoms (55.5% and 53.7%, respectively). Thirty-one cases (57.4%) occurred in the absence of COVID-19\u2013associated pneumonia. Twenty-one (38.9%) had a fulminant presentation requiring inotropic support or temporary mechanical circulatory support. The composite of in-hospital mortality or temporary mechanical circulatory support occurred in 20.4%. At 120 days, estimated mortality was 6.6%, 15.1% in patients with associated pneumonia versus 0% in patients without pneumonia (\n                      <jats:italic>P<\/jats:italic>\n                      =0.044). During hospitalization, left ventricular ejection fraction, assessed by echocardiography, improved from a median of 40% on admission to 55% at discharge (n=47;\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.0001) similarly in patients with or without pneumonia. Corticosteroids were frequently administered (55.5%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>AM occurrence is estimated between 2.4 and 4.1 out of 1000 patients hospitalized for COVID-19. The majority of AM occurs in the absence of pneumonia and is often complicated by hemodynamic instability. AM is a rare complication in patients hospitalized for COVID-19, with an outcome that differs on the basis of the presence of concomitant pneumonia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circulationaha.121.056817","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T14:00:25Z","timestamp":1649685625000},"page":"1123-1139","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":204,"title":["Prevalence, Characteristics, and Outcomes of COVID-19\u2013Associated Acute Myocarditis"],"prefix":"10.1161","volume":"145","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1676-5257","authenticated-orcid":true,"given":"Enrico","family":"Ammirati","sequence":"first","affiliation":[{"name":"De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milano, Italy (E.A., M.P., P.P. F.S., M.C., C.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Lupi","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy (L.L., M.D.P., M. Metra)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Palazzini","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milano, Italy (E.A., M.P., P.P. F.S., M.C., C.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0551-7864","authenticated-orcid":true,"given":"Nicholas S.","family":"Hendren","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (N.S.H., J.L.G., J.A.d.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2400-3196","authenticated-orcid":true,"given":"Justin L.","family":"Grodin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (N.S.H., J.L.G., J.A.d.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo V.","family":"Cannistraci","sequence":"additional","affiliation":[{"name":"Center for Complex Network Intelligence, Tsinghua Laboratory of Brain and Intelligence, Department of Computer Science, Department of Biomedical Engineering, Tsinghua University, Beijing, China (C.V.C.)."},{"name":"Center for Systems Biology Dresden, Germany (C.V.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthieu","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, UMRS 1166, Institute of Cardiometabolism and Nutrition, Service de M\u00e9decine Intensive\u2013R\u00e9animation, Institut de Cardiologie, Assistance Publique\u2013H\u00f4pitaux de Paris, H\u00f4pital Piti\u00e9\u2013Salp\u00eatri\u00e8re, France (M. Schmidt, G.H., A. Combes)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guillaume","family":"Hekimian","sequence":"additional","affiliation":[{"name":"Sorbonne Universit\u00e9, UMRS 1166, Institute of Cardiometabolism and Nutrition, Service de M\u00e9decine Intensive\u2013R\u00e9animation, Institut de Cardiologie, Assistance Publique\u2013H\u00f4pitaux de Paris, H\u00f4pital Piti\u00e9\u2013Salp\u00eatri\u00e8re, France (M. Schmidt, G.H., A. Combes)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1815-4000","authenticated-orcid":true,"given":"Giovanni","family":"Peretto","sequence":"additional","affiliation":[{"name":"San Raffaele Hospital and Vita Salute University, Milano, Italy (G.P., S.S., P.G.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5889-7506","authenticated-orcid":true,"given":"Thomas","family":"Bochaton","sequence":"additional","affiliation":[{"name":"Urgences et Soins Critiques Cardiologiques, H\u00f4pital Cardiologique, Hospices Civils de Lyon, Bron, France (T.B., A.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Hayek","sequence":"additional","affiliation":[{"name":"Urgences et Soins Critiques Cardiologiques, H\u00f4pital Cardiologique, Hospices Civils de Lyon, Bron, France (T.B., A.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6677-6552","authenticated-orcid":true,"given":"Nicolas","family":"Piriou","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Nantes, CHU Nantes, Centre National de la Recherche Scientifique, Institut National de la Sant\u00e9 et de la Recherche M\u00e9dicale, l\u2019Institut du Thorax, France (N.P.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Leonardi","sequence":"additional","affiliation":[{"name":"University of Pavia and Fondazione Istituto di Ricovero e Cura a Carattere Scientificio Policlinico S. Matteo, Italy (S.L., S.G., A.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3557-9409","authenticated-orcid":true,"given":"Stefania","family":"Guida","sequence":"additional","affiliation":[{"name":"University of Pavia and Fondazione Istituto di Ricovero e Cura a Carattere Scientificio Policlinico S. Matteo, Italy (S.L., S.G., A.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annalisa","family":"Turco","sequence":"additional","affiliation":[{"name":"University of Pavia and Fondazione Istituto di Ricovero e Cura a Carattere Scientificio Policlinico S. Matteo, Italy (S.L., S.G., A.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3303-8892","authenticated-orcid":true,"given":"Simone","family":"Sala","sequence":"additional","affiliation":[{"name":"San Raffaele Hospital and Vita Salute University, Milano, Italy (G.P., S.S., P.G.C.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6911-7480","authenticated-orcid":true,"given":"Aitor","family":"Uribarri","sequence":"additional","affiliation":[{"name":"Departamento de Cardiolog\u00eda, Hospital Cl\u00ednico Universitario, Valladolid, Spain (A.U.)."},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares, Instituto de Salud Carlos III, Madrid, Spain (A.U.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline M.","family":"Van de Heyning","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Antwerp University Hospital, and Genetics, Pharmacology and Physiopathology of Heart, Blood Vessels and Skeleton Research Group, Antwerp University, Belgium (C.M.V.d.H.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9985-7407","authenticated-orcid":true,"given":"Massimo","family":"Mapelli","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientificio, Milano, Italy (M. Mapelli, J.C., P.A.)."},{"name":"Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Italy (M. Mapelli, J.C., P.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2276-9630","authenticated-orcid":true,"given":"Jeness","family":"Campodonico","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientificio, Milano, Italy (M. Mapelli, J.C., P.A.)."},{"name":"Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Italy (M. Mapelli, J.C., P.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrizia","family":"Pedrotti","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milano, Italy (E.A., M.P., P.P. F.S., M.C., C.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Isabel","family":"Barrionuevo S\u00e1nchez","sequence":"additional","affiliation":[{"name":"Cardiology Department, Bellvitge University Hospital, Bioheart, Grup de Malalties Cardiovasculars, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge, L\u2019Hospotalet del Llobregat, Barcelona, Spain (M.I.B.S., A.A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Ariza Sole","sequence":"additional","affiliation":[{"name":"Cardiology Department, Bellvitge University Hospital, Bioheart, Grup de Malalties Cardiovasculars, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge, Institut d\u2019Investigaci\u00f3 Biom\u00e8dica de Bellvitge, L\u2019Hospotalet del Llobregat, Barcelona, Spain (M.I.B.S., A.A.S.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Marini","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Department, Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona Umberto I\u2013GM Lancisi\u2013G Salesi, Ancona, Italy (M. Marini, M.V.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Vittoria","family":"Matassini","sequence":"additional","affiliation":[{"name":"Cardiology Division, Cardiovascular Department, Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona Umberto I\u2013GM Lancisi\u2013G Salesi, Ancona, Italy (M. Marini, M.V.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1576-7728","authenticated-orcid":true,"given":"Mickael","family":"Vourc\u2019h","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Surgical Intensive Care, H\u00f4pital Laennec, University Hospital of Nantes, France (M.V.)."},{"name":"School of Medicine, UPRES EA 3826, Th\u00e9rapeutiques Cliniques et Exp\u00e9rimentales des Infections, IRS2 Nantes Biotech, France (M.V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7609-6297","authenticated-orcid":true,"given":"Antonio","family":"Cannat\u00e0","sequence":"additional","affiliation":[{"name":"School of Cardiovascular Medicine and Sciences, King\u2019s College London British Heart Foundation Centre of Excellence, James Black Centre, United Kingdom (A. Cannat\u00e0, D.I.B., T.M.)."},{"name":"Department of Cardiology, King\u2019s College Hospital London, United Kingdom (A. Cannat\u00e0, D.I.B., T.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4243-5964","authenticated-orcid":true,"given":"Daniel I.","family":"Bromage","sequence":"additional","affiliation":[{"name":"School of Cardiovascular Medicine and Sciences, King\u2019s College London British Heart Foundation Centre of Excellence, James Black Centre, United Kingdom (A. Cannat\u00e0, D.I.B., T.M.)."},{"name":"Department of Cardiology, King\u2019s College Hospital London, United Kingdom (A. Cannat\u00e0, D.I.B., T.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Briguglia","sequence":"additional","affiliation":[{"name":"Mater Domini Humanitas Hospital, Castellanza, Italy (D.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5067-5052","authenticated-orcid":true,"given":"Jorge","family":"Salamanca","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario De La Princesa, Madrid, Spain (J.S., P.D.-V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pablo","family":"Diez-Villanueva","sequence":"additional","affiliation":[{"name":"Cardiology Department, Hospital Universitario De La Princesa, Madrid, Spain (J.S., P.D.-V.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jukka","family":"Lehtonen","sequence":"additional","affiliation":[{"name":"Heart and Lung Center, Department of Cardiology, Helsinki University Hospital, Finland (J.L.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3063-1546","authenticated-orcid":true,"given":"Florent","family":"Huang","sequence":"additional","affiliation":[{"name":"Service de Cardiologie, H\u00f4pital Foch, Suresnes, France (F.H., S. Russel)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"St\u00e9phanie","family":"Russel","sequence":"additional","affiliation":[{"name":"Service de Cardiologie, H\u00f4pital Foch, Suresnes, France (F.H., S. Russel)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Soriano","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milano, Italy (E.A., M.P., P.P. F.S., M.C., C.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Turrini","sequence":"additional","affiliation":[{"name":"Ospedale Civile di Baggiovara, Modena, Italy (F.T.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manlio","family":"Cipriani","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milano, Italy (E.A., M.P., P.P. F.S., M.C., C.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Bramerio","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Niguarda Hospital, Milano, Italy (M.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4499-7725","authenticated-orcid":true,"given":"Mattia","family":"Di Pasquale","sequence":"additional","affiliation":[{"name":"Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy (L.L., M.D.P., M. Metra)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aurelia","family":"Grosu","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy (A.G., M. Senni)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Senni","sequence":"additional","affiliation":[{"name":"Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy (A.G., M. Senni)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4075-0001","authenticated-orcid":true,"given":"Davide","family":"Farina","sequence":"additional","affiliation":[{"name":"Institute of Radiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Italy (D.F.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8345-6382","authenticated-orcid":true,"given":"Piergiuseppe","family":"Agostoni","sequence":"additional","affiliation":[{"name":"Centro Cardiologico Monzino Istituto di Ricovero e Cura a Carattere Scientificio, Milano, Italy (M. Mapelli, J.C., P.A.)."},{"name":"Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milano, Italy (M. Mapelli, J.C., P.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8575-1748","authenticated-orcid":true,"given":"Stefania","family":"Rizzo","sequence":"additional","affiliation":[{"name":"Cardiovascular Pathology Unit, Azienda Ospedaliera, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Italy (S. Rizzo, M.D.G., C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9528-4883","authenticated-orcid":true,"given":"Monica","family":"De Gaspari","sequence":"additional","affiliation":[{"name":"Cardiovascular Pathology Unit, Azienda Ospedaliera, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Italy (S. Rizzo, M.D.G., C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5537-9589","authenticated-orcid":true,"given":"Francesca","family":"Marzo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Infermi Hospital, Rimini, Italy (F.M.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1666-2319","authenticated-orcid":true,"given":"Jason M.","family":"Duran","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of California San Diego (J.M.D., E.D.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric D.","family":"Adler","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, University of California San Diego (J.M.D., E.D.A.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Giannattasio","sequence":"additional","affiliation":[{"name":"De Gasperis Cardio Center and Transplant Center, Niguarda Hospital, Milano, Italy (E.A., M.P., P.P. F.S., M.C., C.G.)."},{"name":"Department of Health Sciences, University of Milano-Bicocca, Monza, Italy (C.G.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0195-9753","authenticated-orcid":true,"given":"Cristina","family":"Basso","sequence":"additional","affiliation":[{"name":"Cardiovascular Pathology Unit, Azienda Ospedaliera, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Italy (S. Rizzo, M.D.G., C.B.)."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"McDonagh","sequence":"additional","affiliation":[{"name":"School of Cardiovascular Medicine and Sciences, King\u2019s College London British Heart Foundation Centre of Excellence, James Black Centre, United Kingdom (A. Cannat\u00e0, D.I.B., T.M.)."},{"name":"Department of Cardiology, King\u2019s College Hospital London, United Kingdom (A. 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