Endocarditis in patients with cocaine or opioid use disorder saw marked increase between 2011 to 2022

Tuesday, December 13, 2022

Steep, recent increase indicates COVID-19 associated with higher risk of endocarditis, NIH-supported study finds

The incidence rate of infective endocarditis — a rare but often fatal inflammation of the heart valves — among patients with cocaine use disorder or opioid use disorder increased from 2011 to 2022, with the steepest increase occurring from 2021 to 2022, a new study reports. Study findings contribute to expanding evidence of endocarditis as a significant and growing health concern for people who inject drugs, and further demonstrate that this risk has been exacerbated during the COVID-19 pandemic.

Among patients with either substance use disorder, those who were clinically diagnosed with COVID-19 faced a higher risk of a new endocarditis diagnosis as well as hospitalization following this diagnosis than those without COVID-19. Over the full 12-year period, the rate of endocarditis was three to eight times greater in patients with opioid and cocaine use disorder than those without.

The findings also showed that Black and Hispanic people faced a lower risk of COVID-19-associated endocarditis than non-Hispanic white people. The authors note this is consistent with higher prevalence of injection drug use in non-Hispanic white populations, compared to black or Hispanic populations. The study published today in Molecular Psychiatry, funded by agencies across the National Institutes of Health and led by the National Institute on Drug Abuse (NIDA).

“People with substance use disorder already face major impediments to proper healthcare due to lack of access and stigma,” said NIDA Director and co-corresponding study author, Nora D. Volkow, M.D. “Proven techniques like syringe service programs, which help people avoid infection from re-used or shared injection equipment, can help prevent this often fatal and costly condition.”