Cardiac Complications Associated with COVID-19, MIS-C, and mRNA COVID-19 Vaccination

Chin, Stephanie E.; Bhavsar, Sejal Makvana; Corson, Andrew; Ghersin, Zelda J.; Kim, Hannah S.

doi:10.1007/s00246-022-02851-x

Cited by 25 publications

(23 citation statements)

References 34 publications

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“…Currently, long-term cardiovascular effects of MIS-C are not known yet. Patients have both acute and subacute complications and cardiovascular manifestations vary from mild to severe [ 63 ]. Thus, the results of a systematic review with meta-analysis, where there were 27 studies and it included 917 patients with MIS-C, the average age was 9.3 years old (95% confidence interval (CI), 8.4–10.1) [ 64 ].…”

Section: Multisystem Inflammatory Syndrome Associated With Covid-19 I...mentioning

confidence: 99%

“…It should be noted that MIS-C can look like Kawasaki disease, based on clinical and laboratory signs. However, the high frequency of damage is typical for MIS-C in African Americans and Latin Americans and the prevalence in older age (the average age is 9) and, probably, a higher incidence of myocarditis, an elevation of troponin, ventricular dysfunction, and need for vasopressor drugs [ 63 ].…”

Section: Multisystem Inflammatory Syndrome Associated With Covid-19 I...mentioning

confidence: 99%

“…Patients had a mild increase of troponin and then a rapid restoration of the LV function against the therapy background [ 27 , 37 , 64 , 68 ]. Nevertheless, there is evidence that diastolic dysfunction can last for 6 months after an acute disease in some patients [ 63 ].…”

Section: Multisystem Inflammatory Syndrome Associated With Covid-19 I...mentioning

confidence: 99%

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COVID-19 Heart Lesions in Children: Clinical, Diagnostic and Immunological Changes

Васичкина

Alekseeva

Kudryavtsev

et al. 2023

IJMS

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In the beginning of COVID-19, the proportion of confirmed cases in the pediatric population was relatively small and there was an opinion that children often had a mild or asymptomatic course of infection. Our understanding of the immune response, diagnosis and treatment of COVID-19 is highly oriented towards the adult population. At the same time, despite the fact that COVID-19 in children usually occurs in a mild form, there is an incomplete understanding of the course as an acute infection and its subsequent manifestations such as Long-COVID-19 or Post-COVID-19, PASC in the pediatric population, correlations with comorbidities and immunological changes. In mild COVID-19 in childhood, some authors explain the absence of population decreasing T and B lymphocytes. Regardless of the patient’s condition, they can have the second phase, related to the exacerbation of inflammation in the heart tissue even if the viral infection was completely eliminated—post infectious myocarditis. Mechanism of myocardial dysfunction development in MIS-C are not fully understood. It is known that various immunocompetent cells, including both resident inflammatory cells of peripheral tissues (for example macrophages, dendritic cells, resident memory T-lymphocytes and so on) and also circulating in the peripheral blood immune cells play an important role in the immunopathogenesis of myocarditis. It is expected that hyperproduction of interferons and the enhanced cytokine response of T cells 1 and 2 types contribute to dysfunction of the myocardium. However, the role of Th1 in the pathogenesis of myocarditis remains highly controversial. At the same time, the clinical manifestations and mechanisms of damage, including the heart, both against the background and after COVID-19, in children differ from adults. Further studies are needed to evaluate whether transient or persistent cardiac complications are associated with long-term adverse cardiac events.

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Section: Multisystem Inflammatory Syndrome Associated With Covid-19 I...mentioning

confidence: 99%

Section: Multisystem Inflammatory Syndrome Associated With Covid-19 I...mentioning

confidence: 99%

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COVID-19 Heart Lesions in Children: Clinical, Diagnostic and Immunological Changes

Васичкина

Alekseeva

Kudryavtsev

et al. 2023

IJMS

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“…Anakinra, which has immunosuppressive activity by blocking interleukin-1 receptors, has also been shown to be effective in patients with MIS-CH [14]. A number of researchers consider the use of metipred in the early stages to block secondary inflammatory processes in the treatment of children with multisystem inflammatory syndrome by strictly controlling the concentration of CRP and leukocytes in the blood [15]. Also W.J.…”

Section: Discussionmentioning

confidence: 99%

"Role and Correlation of Laboratory Biomarkers in the Assessment of Severe COVID-19 in Children"

Namazova¹

2022

BJSTR

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At the end of 2019, the coronavirus infection quickly spread around the world and WHO declared the beginning of a pandemic on March 11, 2020. To this end, the authors decided to study the role of some laboratory biomarkers in assessing the severity of the course of the disease Covid-19 in children and the correlation between them. 551 patients applied to the Department of Pediatric Infectious Diseases. 55 patients without comorbidity, with confirmed "Upper Respiratory Diseases" were treated on an outpatient basis and entered the control group. 496 patients were diagnosed with Covid-19 and were included in the study group. Of the patients, 364 children were laboratory positive for C-19 and belonged to group I (covid pediatric). Laboratory C-19 in 132 children was assigned to the negative-II group (MIS-Ch). Patients were diagnosed with a number of biomarkers (inflammatory, respiratory and metabolic panel, coagulogram, interleukin-6, brain natriuretic peptide concentration) in the blood and the correlation between them. When comparing patients of groups I and II, it was found that the concentration of biomarkers was higher in patients of group II. This once again proves that the Covid-19 disease is more severe in patients of group II. In both groups, the correlation coefficient between biomarkers was also studied. Thus, there is a direct strong correlation between creatine kinase-MB and ferritin in group I and BNP and interleukin-6 in group II, and it is statistically significant.

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“…However, due to the milder clinical course compared to classic MYO and MIS-C MYO, strong pharmacologic support is only rarely required in patients with COVID-19 vaccine-related MYO. Use of non-steroidal anti-inflammatory drugs, immune globulin (IVIG), and steroids is not common ( 48 ) and remains controversial ( 49 ). A pediatric study comparing drug use in patients with viral MYO, MIS-C MYO and vaccine-related MYO has shown that intravenous immunoglobulin (IVIG) and steroids were frequently used in patients with classic MYO and MIS-C MYO but in only one and in none of the 9 patients with previous COVID-19 immunization ( 50 ).…”

Section: Clinical Characteristics and Outcome Of Myocarditis Associat...mentioning

confidence: 99%

Myocarditis Following COVID-19 Vaccine Use: Can It Play a Role for Conditioning Immunization Schedules?

Esposito

Caminiti

Giordano³

et al. 2022

Front. Immunol.

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Myocarditis (MYO) is a relatively uncommon inflammatory disease that involves the heart muscle. It can be a very severe disease as it can lead to the development of acute or chronic heart failure and, in a not marginal number of cases, to death. Most of the cases are diagnosed in healthy people younger than 30 years of age. Moreover, males are affected about twice as much as females. Viruses are among the most common causes of MYO, but how viral infection can lead to MYO development is not precisely defined. After COVID-19 pandemic declaration, incidence rate of MYO has significantly increased worldwide because of the SARS-CoV-2 infection. After the introduction of anti-COVID-19 vaccines, reports of post-immunization MYO have emerged, suggesting that a further cause of MYO together with the SARS-CoV-2 infection could increase the risk of heart damage during pandemic. Main aim of this study is to discuss present knowledge regarding etiopathogenesis and clinical findings of MYO associated with COVID-19 vaccine administration and whether the risk of this adverse events can modify the initially suggested recommendation for the use of COVID-19 vaccines in pediatric age. Literature analysis showed that MYO is an adverse event that can follow the COVID-19 immunization with mRNA vaccines in few persons, particularly young adults, adolescents, and older children. It is generally a mild disease that should not modify the present recommendations for immunization with the authorized COVID-19 mRNA vaccines. Despite this, further studies are needed to evaluate presently undefined aspects of MYO development after COVID-19 vaccine administration and reduce the risk of development of this kind of vaccine complication. Together with a better definition of the true incidence of MYO and the exact role of the various factors in conditioning incidence variations, it is essential to establish long-term evolution of acute COVID-19 related MYO.

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Cardiac Complications Associated with COVID-19, MIS-C, and mRNA COVID-19 Vaccination

Cited by 25 publications

References 34 publications

COVID-19 Heart Lesions in Children: Clinical, Diagnostic and Immunological Changes

COVID-19 Heart Lesions in Children: Clinical, Diagnostic and Immunological Changes

"Role and Correlation of Laboratory Biomarkers in the Assessment of Severe COVID-19 in Children"

Myocarditis Following COVID-19 Vaccine Use: Can It Play a Role for Conditioning Immunization Schedules?

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