COVID-19 Pandemic Exacerbates Myocarditis-Related Mortality in the United States

Strategic Insights -

Researchers from the Aga Khan University Medical College have conducted a study examining the trends of myocarditis-related mortality in the United States, revealing a significant increase in mortality rates during the COVID-19 pandemic. The study used data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database to analyze long-term trends in mortality, which spanned from 1999 to 2023.

Using the Joinpoint Regression Program, the researchers found that the age-adjusted mortality rate (AAMR) of myocarditis deaths decreased by 46.08% from 7.40 in 1999 to 3.99 in 2019. However, this trend reversed during the pandemic, with a 46.62% increase in AAMR from 2019 to 2021. By 2023, the AAMR had recovered to 4.33, but mortality was still higher than expected from pre-pandemic trends.

Notably, COVID-19 infection contributed to 70.33% of excess myocarditis-related deaths, with a peak of 76.15% in 2021. Significant disparities persisted in mortality trends, with males, NH Black or African Americans, and the elderly having higher mortality rates.

Key Takeaways:

  • Myocarditis-related mortality in the United States decreased from 1999 to 2019 but significantly increased during the COVID-19 pandemic years 2020 and 2021.
  • The age-adjusted mortality rate (AAMR) of myocarditis deaths decreased by 46.08% from 7.40 in 1999 to 3.99 in 2019.
  • The AAMR increased by 46.62% from 2019 to 2021, reversing the gains of the previous two decades.
  • COVID-19 infection contributed to 70.33% of excess myocarditis-related deaths, with a peak of 76.15% in 2021.
  • Significant disparities persisted in mortality trends, with males, NH Black or African Americans, and the elderly having higher mortality rates.
  • 54.94% higher mortality was observed in 2021 compared to the expected mortality rates.

Statistics:

  • 33,016 myocarditis-related deaths from 1999 to 2023.
  • 46.08% decrease in AAMR from 1999 to 2019.
  • 46.62% increase in AAMR from 2019 to 2021.
  • 70.33% of excess myocarditis-related deaths also had COVID-19.
  • 76.15% of excess myocarditis deaths in 2021 involved COVID-19 infection.
  • 54.94% higher mortality in 2021 compared to expected mortality rates.
  • 40.12% more deaths than expected from 2020 to 2023.

Sources:

  • Declining Myocarditis Mortality in the United States and the Impact of the COVID-19 Pandemic. Journal of Clinical Medicine, 2025;14(14):5116.
  • Medical Letter on the CDC & FDA. August 17, 2025; p 82.
  • Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database.