Clinical Characteristics of Patients with Myocarditis following COVID-19 mRNA Vaccination: A Systematic Review and Meta-Analysis

Matar, Reem; Mansour, Rania; Nakanishi, Hayato; Smayra, Karen; Haddad, Joe El; Vankayalapati, Dilip K.; Daniel, Rohan Suresh; Tosovic, Danijel; Than, Christian; Yamani, Mohamad H.

doi:10.3390/jcm11154521

“…The global rate of COVID-19 vaccination is increasing rapidly. [3][4][5] Although vaccinations significantly protect us from viral infections, there is increasing evidence of various cardiovascular adverse events after vaccination for COVID-19, including cardiac arrythmias. Our systematic review and meta-analysis showed that the incidence of arrhythmia was significantly higher in people who received COVID-19 vaccines than in people who received non-COVID-19 vaccines (Figure 2), with the exception of smallpox vaccine.…”

Section: Discussionmentioning

confidence: 99%

“…2 Although COVID-19 vaccines are generally considered safe, adverse events after vaccination, such as thromboembolisms, myocarditis, and arrhythmia, are increasingly being reported. [3][4][5] Arrhythmias are a known but rare adverse reaction to viral vaccination and have also occurred after other vaccinations, including those for smallpox and human papillomavirus (HPV). [6][7][8] The mRNA COVID-19 vaccines trigger innate immunity, cytotoxicity, and helper T cells, especially B cells, to promote the induction of neutralizing antibodies 9 ; however, these reactions can also affect the cardiovascular system and cause serious adverse events, including arrhythmia.…”

Section: Introductionmentioning

confidence: 99%

“…2 Although COVID-19 vaccines are generally considered safe, adverse events after vaccination, such as thromboembolisms, myocarditis, and arrhythmia, are increasingly being reported. 3-5 Arrhythmias are a known but rare adverse reaction to viral vaccination and have also occurred after other vaccinations, including those for smallpox and human papillomavirus (HPV). 6-8…”

Section: Introductionmentioning

confidence: 99%

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Cardiac Arrhythmia after COVID-19 Vaccination versus Non–COVID-19 Vaccination: A Systematic Review and Meta-Analysis

Shi

¹

,

Tang

²

,

Xia

³

et al. 2022

Preprint

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Aims: Cardiac arrhythmia is a rare complication after vaccination. Recently, reports of arrhythmia after COVID-19 vaccination have increased. Whether the risk for cardiac arrhythmia is higher with COVID-19 vaccines than with non-COVID-19 vaccines remains controversial. This meta-analysis explored the incidence of arrhythmia after COVID-19 vaccination and compared it with the incidence of arrhythmia after non-COVID-19 vaccination. Methods: We searched the MEDLINE, Scopus, Cochrane Library, and Embase databases for English-language studies reporting the incidence of arrhythmia (the primary endpoint) after vaccination from January 1, 1947 to October 28, 2022. Secondary endpoints included incidence of tachyarrhythmia and all-cause mortality. Subgroup analyses were conducted to evaluate the incidence of arrhythmia by age (children [<18 years] versus adults [≥18 years]), vaccine type (mRNA COVID-19 vaccine versus non-mRNA COVID-19 vaccine; individual non-COVID-19 vaccines versus COVID-19 vaccine), and COVID-19 vaccine dose (first versus second versus third). Random-effects meta-analyses were performed, and the intrastudy risk for bias and the certainty of evidence were evaluated. This study was registered with PROSPERO (CRD42022365912). Results: The overall incidence of arrhythmia from 36 studies (1,528,459,662 vaccine doses) was 291.8 (95% CI 111.6-762.7) cases per million doses. The incidence of arrhythmia was significantly higher after COVID-19 vaccination (2263.4 [875.4-5839.2] cases per million doses; 830,585,553 doses, 23 studies) than after non-COVID-19 vaccination (9.9 [1.3-75.5] cases per million doses; 697,874,109 doses, 14 studies; P<0.01). Compared with COVID-19 vaccines, the influenza, pertussis, human papillomavirus, and acellular pertussis vaccines were associated with a significantly lower incidence of arrhythmia. The incidence of tachyarrhythmia was significantly higher after COVID-19 vaccination (4367.5 [1535.2-12,360.8] cases per million doses; 1,208,656 doses, 15 studies) than after non-COVID-19 vaccination (25.8 [4.5-149.4] cases per million doses; 179,822,553 doses, 11 studies; P<0.01). Arrhythmia was also more frequent after the third dose of COVID-19 vaccine (19,064.3 [5775.5-61,051.2] cases per million doses; 7968 doses, 3 studies) than after the first dose (3450.9 [988.2-11,977.6] cases per million doses; 41,714,762 doses, 12 studies; P=0.05) or second dose (2262.5 [2205.9-2320.7] cases per million doses; 34,540,749 doses, 10 studies; P<0.01). All-cause mortality was comparable between the COVID-19 and non-COVID-19 vaccination groups. Conclusions: The overall risk for arrhythmia after COVID-19 vaccination was relatively low, although it was higher in COVID-19 vaccine recipients than in non-COVID-19 vaccine recipients. This increased risk should be evaluated along with other important factors, such as the incidence of local outbreaks and the risk for arrhythmia due to COVID infection itself, when weighing the safety and efficacy of COVID-19 vaccines.

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“…With regard to cardiovascular medicine, it is desirable to know specific genetic risk factors for the development of myocarditis during COVID-19 or upon vaccination [112,[165][166][167][168][169][170][226][227][228][229][230][231][232], or for development of long COVID syndromes [191,[233][234][235][236][237][238][239]. Fortunately, SARS-CoV-2 is rather rarely causing severe myocarditis or cardiomyopathies [165][166][167][168][169][170].…”

Section: Cardiovascular Immunobiology Of Covid-19 and Long Covid Synd...mentioning

confidence: 99%

Innate Immunity in Cardiovascular Diseases – Identification of Novel Molecular Players and Targets

Poller¹,

Heidecker²,

Ammirati³

et al. 2022

Preprint

0

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During the past few years unexpected developments have driven studies in the field of clinical immunology. One driver of immense impact was the outbreak of a pandemic caused by the novel virus SARS-CoV-2. Excellent recent reviews address diverse aspects of immunological re-search into cardiovascular diseases. Here, we specifically focus on selected studies taking ad-vantage of advanced state-of-the-art molecular genetic methods ranging from genome-wide epi/transcriptome mapping and variant scanning to optogenetics and chemogenetics. First, we discuss emerging clinical relevance of advanced diagnostics for cardiovascular diseases - includ-ing those associated with COVID-19 - with a focus on the role of inflammation in cardiomyopa-thies and arrhythmias. Second, we consider newly identified immunological interactions at or-gan and systems level which affect cardiovascular pathogenesis. Thus, studies into immune in-fluences arising from the intestinal system are moving towards therapeutic exploitation. Fur-ther, powerful new research tools have enabled novel insight into brain – immune system inter-actions at unprecedented resolution. This latter line of investigation emphasizes the strength of influence of emotional stress - acting through defined brain regions - upon viral and cardiovas-cular disorders. Several challenges need to be overcome before the full impact of these far-reaching new findings will hit the clinical arena.

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“…With regard to cardiovascular medicine, it is desirable to know specific genetic risk factors for the development of myocarditis during COVID-19 or upon vaccination [112,[164][165][166][167][168][169][204][205][206][207][208][209], or for development of long COVID syndromes [190,[210][211][212][213].…”

Section: Cardiovascular Immunobiology Of Covid-19 and Long Covid Synd...mentioning

confidence: 99%

Innate Immunity in Cardiovascular Diseases – Identification of Novel Molecular Players and Targets

Poller¹,

Heidecker²,

Ammirati³

et al. 2022

Preprint

0

View full text Add to dashboard Cite

During the past few years unexpected developments have driven studies in the field of clinical immunology. One driver of immense impact was the outbreak of a pandemic caused by the novel virus SARS-CoV-2. Excellent recent reviews address diverse aspects of immunological re-search into cardiovascular diseases. Here, we specifically focus on selected studies taking ad-vantage of advanced state-of-the-art molecular genetic methods ranging from genome-wide epi/transcriptome mapping and variant scanning to optogenetics and chemogenetics. First, we discuss emerging clinical relevance of advanced diagnostics for cardiovascular diseases - includ-ing those associated with COVID-19 - with a focus on the role of inflammation in cardiomyopa-thies and arrhythmias. Second, we consider newly identified immunological interactions at or-gan and systems level which affect cardiovascular pathogenesis. Thus, studies into immune in-fluences arising from the intestinal system are moving towards therapeutic exploitation. Fur-ther, powerful new research tools have enabled novel insight into brain – immune system inter-actions at unprecedented resolution. This latter line of investigation emphasizes the strength of influence of emotional stress - acting through defined brain regions - upon viral and cardiovas-cular disorders. Several challenges need to be overcome before the full impact of these far-reaching new findings will hit the clinical arena.

show abstract

Clinical Characteristics of Patients with Myocarditis following COVID-19 mRNA Vaccination: A Systematic Review and Meta-Analysis

Cited by 8 publications

References 125 publications

Cardiac Arrhythmia after COVID-19 Vaccination versus Non–COVID-19 Vaccination: A Systematic Review and Meta-Analysis

Cardiac Arrhythmia after COVID-19 Vaccination versus Non–COVID-19 Vaccination: A Systematic Review and Meta-Analysis

Innate Immunity in Cardiovascular Diseases – Identification of Novel Molecular Players and Targets

Innate Immunity in Cardiovascular Diseases – Identification of Novel Molecular Players and Targets

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