Acute myocarditis associated with COVID-19 vaccination: A case report

Nagasaka, Takashi; Koitabashi, Norimichi; Ishibashi, Yasunori; Aihara, Kazufumi; Takama, Noriaki; Ohyama, Yoshiaki; Yokoyama, Tetsuji; Kaneko, Yoshiaki

doi:10.1016/j.jccase.2021.11.006

Cited by 18 publications

(20 citation statements)

References 10 publications

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“…In Japan, there have been some case reports of myocarditis since the start of COVID-19 vaccination [ 4 , 5 ], but there are no reports of myocarditis in teenagers. Our patient was a healthy 13-year-old male adolescent with no previous medical history.…”

Section: Discussionmentioning

confidence: 99%

“…In Japan, vaccination against COVID-19 began in February 2021 for adults aged 18 and over and was expanded to young people aged 12 and over in June 2021. Since then, some cases have been reported in the Japanese population, but none has been reported amongst teenagers [ 4 , 5 ]. This case report describes a 13-year-old male adolescent who developed myocarditis after receiving the second vaccination dose of the BNT162b2 mRNA vaccine.…”

Section: Introductionmentioning

confidence: 99%

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Myocarditis Following the Second Dose of COVID-19 Vaccination in a Japanese Adolescent

Yamamoto¹,

Arita²,

Ogasawara³

2022

Cureus

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As COVID-19 vaccines continue to be deployed worldwide, countries are now planning to vaccinate their pediatric populations as well. However, several vaccine-related adverse events, including myocarditis, have been reported. Although the incidence of myocarditis after BNT162b2 vaccination is low, it is higher, particularly after receiving the second dose, among young male recipients. A 13-year-old male adolescent presented with chest pain after the second dose of the BNT162b2 vaccination. Electrocardiography, echocardiography, cardiac magnetic resonance imaging, and blood examinations were consistent with myocarditis. He was treated conservatively because his symptoms were relatively mild. In Japan, it is expected that the chances of diagnosing vaccine-related myocarditis will increase as more children are getting vaccinated. Our case report raises concerns to physicians that the COVID-19 vaccination may cause rare cases of myocarditis, which must always be considered as a differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Myocarditis Following the Second Dose of COVID-19 Vaccination in a Japanese Adolescent

Yamamoto¹,

Arita²,

Ogasawara³

2022

Cureus

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“…We found around 25 studies that met our criteria. After excluding duplication, we finally included 14 published articles in our study, which consists of 40 case reports (Table 1) [1,[5][6][7][8][9][10][11][12][13][14][15][16][17] of myocarditis after receiving the COVID-19 vaccine.…”

Section: Eligibility Criteriamentioning

confidence: 99%

COVID-19 Vaccine-Related Myocarditis: A Descriptive Study of 40 Case Reports

Chen¹,

Ikwuanusi²,

Bommu³

et al. 2022

Cureus

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After the surging rise in the Coronavirus disease 2019 (COVID-19) pandemic, the Food and Drug Administration (FDA) approved emergency approval of vaccinations to prevent life-threatening complications of COVID-19 infection. These vaccines are BNT162b2, mRNA-1273. Later, the FDA also approved JNJ-78436735. COVID-19 vaccination does not have major side effects, but there are some concerning adverse events reported right after vaccination. Myocarditis is one of them. Based on our analysis of 40 case reports, we are presenting the epidemiology and clinical picture of myocarditis related to the COVID-19 vaccine.Based on our analysis, we found that the majority of cases were seen in males with 90% predominance, and these cases were seen in the age group of 29.13 years old (mean, SD of 14.39 years). In 65% of cases, patients took the BNT162b2 vaccine; 30% of cases were reported with the mRNA-1273 vaccine; and 5% of cases with JNJ-78436735. Of all the cases, 80% of them are reported after the second dose of the vaccine with either Moderna or Pfizer.The characteristics of COVID-19 vaccine-related myocarditis were analyzed in this study. We identified several findings, ranging from age, gender, type of vaccination, presentation of symptoms, and diagnosis modality. This depicts the picture of COVID-19 vaccine-related myocarditis and what physicians should expect when dealing with the disease. Our analysis showed that more cases were reported after receiving the BNT162b2 vaccine compared to mRNA-1273 and JNJ-78436735 vaccines. Further research needs to be conducted to analyze the underlying cause of this association.

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“…While the majority of published cases are based on cardiac magnetic resonance imaging (cMRI) and laboratory evaluation [2][3][4][5][6][7], endomyocardial biopsy (EMB)-proven cases are limited [8,14,15]. Here, we present a comprehensive analysis of EMBs from 15 patients with the suspicion of myocarditis after vaccination against SARS-CoV-2 and reveal a temporal relation between the vaccination and the occurrence of myocardial inflammation, ranging from mild inflammatory cardiomyopathy to severe active myocarditis and giant cell myocarditis.…”

Section: Introductionmentioning

confidence: 95%

“…Myocarditis and pericarditis have been reported as a potential complication of the COVID-19 mRNA (messenger RNA) vaccines. Since the first observations of myocarditis in response to the Pfizer-BioNTech vaccine in April 2021 [1], numerous case reports, indicating a relationship between COVID-19 vaccination and the occurrence of myocarditis/pericarditis, have been published [2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Intramyocardial Inflammation after COVID-19 Vaccination: An Endomyocardial Biopsy-Proven Case Series

Baumeier

Aleshcheva

Harms

et al. 2022

IJMS

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Myocarditis in response to COVID-19 vaccination has been reported since early 2021. In particular, young male individuals have been identified to exhibit an increased risk of myocardial inflammation following the administration of mRNA-based vaccines. Even though the first epidemiological analyses and numerous case reports investigated potential relationships, endomyocardial biopsy (EMB)-proven cases are limited. Here, we present a comprehensive histopathological analysis of EMBs from 15 patients with reduced ejection fraction (LVEF = 30 (14–39)%) and the clinical suspicion of myocarditis following vaccination with Comirnaty® (Pfizer-BioNTech) (n = 11), Vaxzevria® (AstraZenica) (n = 2) and Janssen® (Johnson & Johnson) (n = 2). Immunohistochemical EMB analyses reveal myocardial inflammation in 14 of 15 patients, with the histopathological diagnosis of active myocarditis according the Dallas criteria (n = 2), severe giant cell myocarditis (n = 2) and inflammatory cardiomyopathy (n = 10). Importantly, infectious causes have been excluded in all patients. The SARS-CoV-2 spike protein has been detected sparsely on cardiomyocytes of nine patients, and differential analysis of inflammatory markers such as CD4+ and CD8+ T cells suggests that the inflammatory response triggered by the vaccine may be of autoimmunological origin. Although a definitive causal relationship between COVID-19 vaccination and the occurrence of myocardial inflammation cannot be demonstrated in this study, data suggest a temporal connection. The expression of SARS-Cov-2 spike protein within the heart and the dominance of CD4+ lymphocytic infiltrates indicate an autoimmunological response to the vaccination.

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Acute myocarditis associated with COVID-19 vaccination: A case report

Cited by 18 publications

References 10 publications

Myocarditis Following the Second Dose of COVID-19 Vaccination in a Japanese Adolescent

Myocarditis Following the Second Dose of COVID-19 Vaccination in a Japanese Adolescent

COVID-19 Vaccine-Related Myocarditis: A Descriptive Study of 40 Case Reports

Intramyocardial Inflammation after COVID-19 Vaccination: An Endomyocardial Biopsy-Proven Case Series

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