Carditis, including myocarditis, pericarditis, and endocarditis, is a rare but serious complication of SARS-CoV-2 infection. This observational cohort study published in the Clinical Research in Cardiology analyzed electronic health records from the Montefiore Health System between 2016 and 2024 to assess long-term outcomes among patients who developed carditis within 30 days of COVID-19 diagnosis. 

Three groups were compared: COVID-19–positive patients with carditis (n=226), COVID-19–positive patients without carditis (n=42,758), and pre-pandemic carditis controls (n=2,107). Major adverse cardiovascular events (MACE) and all-cause mortality occurring from 30 days through 5 years after the index event were evaluated using multivariable Cox regression adjusted for demographics, comorbidities, and social determinants of health.

Over a median follow-up of 22 months, COVID-19–associated carditis was associated with a significantly higher MACE risk compared with COVID-19 patients without carditis (adjusted HR, 2.99; 95% CI, 2.18-4.10). All-cause mortality was also higher in COVID-19 carditis survivors than in pre-pandemic carditis patients (adjusted HR, 2.75; 95% CI, 1.93–3.91). Among COVID-19 cases, myocarditis was associated with the lowest left ventricular ejection fraction and highest troponin levels during acute illness, followed by endocarditis and pericarditis.

These findings indicate elevated long-term cardiovascular and mortality risks among survivors of COVID-19–associated carditis. Longitudinal surveillance and tailored cardiovascular care are warranted in this population.