Global burden of myocarditis from 1990 to 2021: findings from the Global Burden of Disease Study 2021

Abstract

BACKGROUND: Myocarditis is a major public health, social, and economic issue. Currently, few studies have provided comprehensive analyses of the global burden of myocarditis based on GBD (Global Burden Disease) 2021. We therefore analyzed long-term trends in the global burden of myocarditis from 1990 to 2021, described risk factors, examined the impact of COVID-19 (coronavirus infection disease 2019), and predicted future trends to inform health policy development and healthcare resource allocation. METHOD: From the GBD 2021 database, incident cases, deaths, and DALYs (disability-adjusted life years) were obtained for countries, regions, ages, and sexes globally. The estimated annual percentage change (EAPC) was used to analyze Trends in age-standardized rates of myocarditis and significant time points were examined using joinpoint regression analysis. RESULTS: Globally, the age-standardized incidence rate (ASIR), DALYs rate (ASDALYsR), and death rate (ASDR) for myocarditis in 2021 were 16.16 [(13.11 to 19.76) per 100 000 people], 12.41 [10.37 to 14.76) per 100 000 people], and 0.40 [0.32 to 0.47) per 100 000 people], respectively. High-income Asia Pacific had the highest myocarditis ASIR in 2021, whereas Central Europe had the highest ASDALYsR and ASDR. Gender comparison showed myocarditis was more common in men. The burden of myocarditis was larger in the elderly aged 80 and older, but children should not be neglected. Analysis revealed a rise in worldwide ASIR from 2016 to 2021 (APC = 0.0945, 95%CI: 0.0709 to 0.1440, p < 0.001). During COVID-19, myocarditis burden did not peak. Both high and low temperatures increase myocarditis risk. The Bayesian age-period-cohort (BAPC) model predicted that myocarditis ASIR would rise while ASDALYsR and ASDR would decrease. CONCLUSIONS: The global burden of myocarditis remains a health issue that cannot be ignored and shows significant regional and sex-based differences. Effective and targeted strategies for the prevention and management of myocarditis in this population are needed to reduce the overall burden. CLINICAL TRIAL NUMBER: Not applicable.