Israeli Study Has Flaws
I discussed the Israeli study on this Monday
Here are some points for why this study should not be used to make clinical decisions.
My video on this topic
https://www.youtube.com/live/d124hJrTtyc?feature=share
Notes:
Context: Israeli study claims that the COVID infection does not cause more myocarditis and pericarditis.
I had compared the Israeli study with the US and German studies in the video above. In summary the Israeli study has the following gaps: they did not use all myocarditis and pericarditis codes. I am sure if the same codes are applied to other studies the results will be the same. Or if the ICD 10 codes from the other studies are applied to the Israeli study the results will become the same. This also means that the Israeli study is dangerously misleading. For an analogy, imagine you are sick and have cough, breathing issues, muscle aches, and joint pains. The researchers observe you and enroll you as a COVID patient, however, they only observe the shortness of breath that requires oxygen (that you don’t have), and then the researchers declare that COVID does not cause breathing issues. In the Israeli study the researchers only used unspecified myocarditis and unspecified pericarditis codes. There logic is that the other codes cover other reasons for the myocarditis and pericarditis. So, kind of partial data usage.
Secondly, the Israeli study researchers discounted the US study by saying that the US study from the veterans database is of the younger population. They concluded that this is the reason that US study shows more myocarditis. There are two problems with this statement; a) actually US study has the mean age of 62 years while Israeli study has the mean age of 42 years. Hence, my understanding is that they Israeli researchers made an incorrect assumption. And, secondly, myocarditis is observed more in younger men from vaccines and not just the COVID. So, generalizing that younger patients have more myocarditis from the infection is baseless.
Conclusion: misleading and dangerous study.
Also, I see that other presenters have been promoting this study as a proof of no harm from COVID, which is not correct.
References
Long-term cardiovascular outcomes of COVID-19 | Nature Medicine
https://www.nature.com/articles/s41591-022-01689-3
41591_2022_1689_MOESM1_ESM.pdf
https://static-content.springer.com/esm/art%3A10.1038%2Fs41591-022-01689-3/MediaObjects/41591_2022_1689_MOESM1_ESM.pdf
The Incidence of Myocarditis and Pericarditis in Post COVID-19 Unvaccinated Patients—A Large Population-Based Study - PMC
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025013/
The Incidence of Myocarditis and Pericarditis in Post COVID-19 Unvaccinated Patients—A Large Population-Based Study - PMC
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9025013/#app1-jcm-11-02219
JCM | Free Full-Text | The Incidence of Myocarditis and Pericarditis in Post COVID-19 Unvaccinated Patients—A Large Population-Based Study
https://www.mdpi.com/2077-0383/11/8/2219/review_report
Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19) - PMC
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7385689/
Cardiac ICD-10 Diagnoses Codes | ECMO | Extracorporeal Membrane Oxygenation
https://www.elso.org/Registry/SupportDocuments/CommonCardiacICD-10DiagnosesCodes.aspx
ICD-10 Code for Acute myocarditis- I40- Codify by AAPC
https://www.aapc.com/codes/icd-10-codes/I40#:~:text=ICD%2D10%20code%20I40%20for,Diseases%20of%20the%20circulatory%20system%20.
ICD-10 Code for Acute pericarditis- I30- Codify by AAPC
https://www.aapc.com/codes/icd-10-codes/I30#:~:text=ICD%2D10%20code%20I30%20for,Diseases%20of%20the%20circulatory%20system%20.
ICD-10 Code for Complications and ill-defined descriptions of heart disease- I51- Codify by AAPC
https://www.aapc.com/codes/icd-10-codes/I51