Letter to the Editor in Response to Sengupta et al. (2022)

We read with interest the prospective cohort study by Sengupta et al., which investigated the impact of socio-economic variations on infective endocarditis (IE).¹

It should be noted, however, that patients from other regions can differ in presentation. The results of the retrospective database analysis by Naidoo et al. show a difference in presentation of IE in South Africa with higher rates of vegetation, embolic events and heart failure compared with Sengupta et al.,² emphasizing the need for large, multi-region cohorts.

The investigation by Marks et al. into the complications of the use of injected drugs highlighted the increase in infectious diseases seen in correlation with the increase in intravenous (i.v.) drug usage.³ This may be an explanation as to why the lower-middle income group saw the highest number of IE cases. This should be explored in further depth.

McNamara et al’s review on the effect of opioid-use-disorder treatment on infectious disease outcomes found that patients with i.v. drug usage benefit more from a flexible treatment course that is easier to complete.⁴ We believe this should be included in the concluding remarks.

We would like to commend Sengupta et al. for publishing these important results.

Disclosures

The authors do not have a conflict of interest regarding this manuscript.

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