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Introduction <p>Leptospirosis is a globally prevalent zoonotic infection caused by Leptospira species. Cardiac involvement is increasingly recognized, yet large-scale studies comprehensively evaluating electrocardiographic and echocardiographic manifestations, including myocarditis, remain limited.</p> Methods <p>This retrospective study included adult patients with clinically suspected leptospirosis and positive IgM ELISA admitted to a tertiary care hospital in South India between January 2016 and September 2020. Clinical features, electrocardiographic (ECG) findings, two-dimensional echocardiographic parameters, and in-hospital outcomes were analyzed. Binomial logistic regression was performed to identify independent predictors of all-cause mortality and myocarditis.</p> Results <p>A total of 510 patients were analyzed (mean age 48.4 ± 13.7 years; 66.5% male). The mean hospital stay was 10.1 ± 6.1 days, with 40% requiring hospitalization beyond 10 days. Diabetes mellitus and hypertension were present in 16.7% and 16.9% of patients, respectively. Acute respiratory distress syndrome occurred in 10.6%, and 28% developed multiorgan dysfunction syndrome; 17.8% required hemodialysis. The most common ECG abnormalities were corrected QT interval prolongation (21.0%) and sinus tachycardia (20.8%). Echocardiographic evidence of myocarditis was observed in 10.4% of patients, including isolated left ventricular dysfunction (4.1%), isolated right ventricular dysfunction (3.9%), and biventricular dysfunction (2.4%). The overall in-hospital mortality rate was 8%. Increasing age, sinus tachycardia, QTc prolongation, hypertension, hemodialysis requirement, and myocarditis were independent predictors of mortality.</p> Conclusions <p>Myocarditis represents a significant cardiac complication in leptospirosis and is associated with increased mortality. Routine cardiac evaluation may facilitate early detection and risk stratification.</p> Clinical trial registration <p>Not applicable, as this study was retrospective in nature.</p> Graphical abstract <p></p>

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Cardiovascular manifestations and outcomes in patients with leptospirosis admitted to a tertiary care center in the Coastal Karnataka region in India

  • 期刊论文

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  • 发表日期：

    2026年5月4日

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  • M. Sudhakar Rao,
  • Jyothi Samanth,
  • Vidya Nayak,
  • R. Padmakumar,
  • Asmitha G. Nayak,
  • P. K. Sanjana Nambiar,
  • Shephali Rajesh Rao,
  • Pratheeksha Rao

摘要

Introduction

Leptospirosis is a globally prevalent zoonotic infection caused by Leptospira species. Cardiac involvement is increasingly recognized, yet large-scale studies comprehensively evaluating electrocardiographic and echocardiographic manifestations, including myocarditis, remain limited.

Methods

This retrospective study included adult patients with clinically suspected leptospirosis and positive IgM ELISA admitted to a tertiary care hospital in South India between January 2016 and September 2020. Clinical features, electrocardiographic (ECG) findings, two-dimensional echocardiographic parameters, and in-hospital outcomes were analyzed. Binomial logistic regression was performed to identify independent predictors of all-cause mortality and myocarditis.

Results

A total of 510 patients were analyzed (mean age 48.4 ± 13.7 years; 66.5% male). The mean hospital stay was 10.1 ± 6.1 days, with 40% requiring hospitalization beyond 10 days. Diabetes mellitus and hypertension were present in 16.7% and 16.9% of patients, respectively. Acute respiratory distress syndrome occurred in 10.6%, and 28% developed multiorgan dysfunction syndrome; 17.8% required hemodialysis. The most common ECG abnormalities were corrected QT interval prolongation (21.0%) and sinus tachycardia (20.8%). Echocardiographic evidence of myocarditis was observed in 10.4% of patients, including isolated left ventricular dysfunction (4.1%), isolated right ventricular dysfunction (3.9%), and biventricular dysfunction (2.4%). The overall in-hospital mortality rate was 8%. Increasing age, sinus tachycardia, QTc prolongation, hypertension, hemodialysis requirement, and myocarditis were independent predictors of mortality.

Conclusions

Myocarditis represents a significant cardiac complication in leptospirosis and is associated with increased mortality. Routine cardiac evaluation may facilitate early detection and risk stratification.

Clinical trial registration

Not applicable, as this study was retrospective in nature.

Graphical abstract