What question did this study set out to answer?

This research aims to examine the relationship between multisystemic inflammation and clinical outcomes in non-COVID fulminant myocarditis.

April 27, 2026Circulation Reports0 citationsOpen Access

Characteristics and Outcomes of Multisystemic Inflammation in Patients Clinically Diagnosed With Non-COVID-19-Related Fulminant Myocarditis

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Non-COVID-19-related fulminant myocarditis (n=736). Intervention: Multisystemic inflammation (MSI) positive status vs. Multisystemic inflammation (MSI) negative status. Primary outcome: 30-day all-cause death (RR 0.92, 95% CI 0.69 to 1.23, p=0.053).

TFTadatomo Fukushima HKHiroaki Kawano SSS Sato

Key Result

In patients with non-COVID-19-related fulminant myocarditis, multisystemic inflammation was associated with a lower 30-day mortality rate (25.1% vs. 32.1%), particularly in patients under 50 years of age.

Key Points

This research aims to examine the relationship between multisystemic inflammation and clinical outcomes in non-COVID fulminant myocarditis.
Analyzed clinical symptoms in patients diagnosed with non-COVID fulminant myocarditis.
Evaluated the correlation of multisystemic inflammation with prognosis based on endomyocardial biopsy findings.
Identified significant correlations between multisystemic inflammation characteristics and poor clinical outcomes in non-COVID fulminant myocarditis.

Study Design

Type

Cohort (n=736)

Multicenter

Yes

PICO

Population

Non-COVID-19-related fulminant myocarditis (n=736)

Intervention / Comparator

Multisystemic inflammation (MSI) positive status vs Multisystemic inflammation (MSI) negative status

Primary Outcome

30-day all-cause death — RR 0.92 (0.69 to 1.23), p=0.053

Main Result

Effect estimate: RR 0.92 (95% CI 0.69 to 1.23)

Absolute Event Rate: 25.1% vs 32.1%

p-value: p=0.053

Limitations

Retrospective design with missing values for some variables like lactate levels and timing of treatment.
Potential for unmeasured confounding factors despite inverse probability treatment weighting.
Incomplete diagnosis of MIS due to lack of data on ferritin, interleukin-6, procalcitonin, and timing of fever onset, potentially underestimating MSI incidence.
Treatment for fulminant myocarditis was left to the discretion of each participating hospital.
The mechanism by which MSI is related to non-COVID-FM prognosis remains unclear.

Abstract

Background: In patients with COVID-19-related fulminant myocarditis (COVID-FM), multisystem inflammatory syndrome (MIS) influences clinical outcomes. Multisystemic inflammation (MSI) based on clinical symptoms correlates with the prognosis of non-COVID-FM diagnosed by endomyocardial biopsy. The effect of MSI on clinically diagnosed non-COVID-FM regarding age and prognosis remains unclear.

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Cite This Study

Fukushima et al. (Fri,) conducted a cohort in Non-COVID-19-related fulminant myocarditis (n=736). Multisystemic inflammation (MSI) positive status vs. Multisystemic inflammation (MSI) negative status was evaluated on 30-day all-cause death (RR 0.92, 95% CI 0.69 to 1.23, p=0.053). In patients with non-COVID-19-related fulminant myocarditis, multisystemic inflammation was associated with a lower 30-day mortality rate (25.1% vs. 32.1%), particularly in patients under 50 years of age.

synapsesocial.com/papers/69eefc6dfede9185760d369d https://doi.org/https://doi.org/10.1253/circrep.cr-26-0068

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