Impact of the SARS-CoV-2 Pandemic on the Management and Prognosis of Infective Endocarditis

TL;DR

This study found that the SARS-CoV-2 pandemic did not worsen the management or outcomes of infective endocarditis patients, though more drug-related cases were observed.

Contribution

The study provides new insights into how the pandemic affected the care and outcomes of infective endocarditis patients in a single center.

Findings

The SARS-CoV-2 pandemic did not negatively impact the management of infective endocarditis patients.

There was a higher proportion of intravenous drug-related infective endocarditis cases during the pandemic.

One-year mortality and recurrence rates remained similar between pre-pandemic and pandemic groups.

Abstract

Background: Infective endocarditis (IE) is a serious condition which is difficult to diagnose and to treat, both medically and surgically. Objectives: The objective of this study was to evaluate the impact of the SARS-CoV-2 pandemic on the management of patients with IE. Methods: We conducted a single-centre retrospective study including patients hospitalized for IE during the pandemic (Group 2) compared with the same period the year before (Group 1). We compared clinical, laboratory, imagery, therapeutic, and patient outcomes between the two groups. Results: A total of 283 patients were managed for possible or definite IE (164 in Group 1 and 119 in Group 2). There were more intravenous drug-related IE patients in Group 2 (p = 0.009). There was no significant difference in surgery including intra-cardiac device extraction (p = 0.412) or time to surgery (p = 0.894). The one-year mortality was similar in both groups (16% versus 17.7%, p = 0.704). The recurrence rate was not significantly different between the two groups (5.9% in Group 2 versus 9.1% in Group 1, p = 0.311). Conclusions: The SARS-CoV-2 pandemic did not appear to have had a negative impact on the management of patients with IE. Maintenance of the activities of the endocarditis team within the referral centre probably contributed to this result. Nevertheless, the high proportion of intravenous drug-addicted patients in the pandemic cohort suggests that the SARS-CoV-2 pandemic had a major psychosocial impact.