Cardiac Complications of Human Babesiosis. (19th August 2022)

• Record Type: Journal Article
• Authors: Spichler-Moffarah, Anne; Ong, Emily; O'Bryan, Jane; Krause, Peter J
• Is Part Of: Clinical infectious diseases. Volume 76:Number 3(2023)
• Page Start: e1385
• Page End: e1391
• Publication Date: 2022-08-19
• Subjects: Babesia microti -- babesiosis -- complications -- heart -- human; Communicable diseases -- Periodicals; 616.905
• DOI: 10.1093/cid/ciac525
• Languages: English
• ISSNs: 1058-4838

Abstract

Abstract: Background: Human babesiosis is a worldwide emerging tick-borne disease caused by intraerythrocytic protozoa. Most patients experience mild to moderate illness, but life-threatening complications can occur. Although cardiac complications are common, the full spectrum of cardiac disease and the frequency, risk factors, and outcomes in patients experiencing cardiac complications are unclear. Accordingly, we carried out a record review of cardiac complications among patients with babesiosis admitted to Yale–New Haven Hospital over the last decade to better characterize cardiac complications of babesiosis. Methods: We reviewed the medical records of all adult patients with babesiosis admitted to Yale–New Haven Hospital from January 2011 to October 2021, confirmed by identification of Babesia parasites on thin blood smear and/or by polymerase chain reaction. The presence of Lyme disease and other tick-borne disease coinfections were recorded. Results: Of 163 enrolled patients, 32 (19.6%) had ≥1 cardiac complication during hospitalization. The most common cardiac complications were atrial fibrillation (9.4%), heart failure (8.6%), corrected QT interval prolongation (8.0%), and cardiac ischemia (6.8%). Neither cardiovascular disease risk factors nor preexisting cardiac conditions were significantly associated with the development of cardiac complications. The cardiac complication group had a greater prevalence of high-grade parasitemia (>10%) ( P < .001), longer median length of both hospital ( P < .001) and intensive care unit stay ( P < .001), and a higher mortality rate ( P = .02) than the group without cardiac complications. Conclusions: Cardiac complications of acute babesiosis are common and occurred in approximately one-fifth of this inpatient sample. Further investigation is needed to elucidate the relationship between babesiosis severity and cardiac outcomes. Abstract : Of 163 hospitalized patients with babesiosis, 20% had ≥1 cardiac complication, including atrial fibrillation and heart failure. Complications were associated with longer hospital and intensive care unit stay and a higher mortality rate. Cardiac complications of severe babesiosis are common and increase disease health burden.