Myocarditis Temporally Associated With COVID-19 Vaccination

Rosner, Carolyn; Genovese, Leonard; Tehrani, Behnam; Atkins, Melany; Bakhshi, Hooman; Chaudhri, Saquib; Damluji, Abdulla; Lemos, James A. de; Desai, Shashank; Emaminia, Abbas; Flanagan, M. Casey; Khera, Amit; Maghsoudi, Alireza; Mekonnen, Girum; Muthukumar, Alagarraju; Saeed, Ibrahim M.; Sherwood, Matthew W.; Sinha, Shashank S.; O’Connor, Christopher M; deFilippi, Christopher R.

doi:10.1161/circulationaha.121.055891

Cited by 195 publications

(230 citation statements)

References 4 publications

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“…Pericarditis affected older patients later, after either the first or second dose. Some vaccines are associated with myocarditis, 5 including mRNA vaccines, [1][2][3][4] and the Centers for Disease Control and Prevention recently reported a possible association between COVID-19 mRNA vaccines and myocarditis, primarily in younger male individuals within a few days after the second vaccination, at an incidence of about 4.8 cases per 1 million. 6 This study shows a similar pattern, although at higher incidence, suggesting vaccine adverse event underreporting.…”

Section: Supplemental Contentmentioning

confidence: 99%

Myocarditis and Pericarditis After Vaccination for COVID-19

Diaz

Parsons

Gering

et al. 2021

JAMA

370

320

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Rare cases of cardiac inflammation following SARS-CoV-2 vaccination have been reported. [1][2][3][4] We reviewed the clinical records of vaccine recipients to identify cases of postvaccination myocarditis or pericarditis.Methods | Forty hospitals in Washington, Oregon, Montana, and Los Angeles County, California, that were part of the Providence health care system and used the same electronic medical record (EMR) were included. All patients with documented COVID-19 vaccinations administered inside the system or recorded in state registries at any time through May 25, 2021, were identified. Vaccinated patients who subsequently had emergency department or inpatient encounters with diagnoses of myocarditis, myopericarditis, or pericarditis were ascertained from EMRs (see eTables 1 and 2 in the Supplement for exclusions and definitions).The monthly rates of first-time hospital diagnoses (excluding patients with previous diagnoses in January 2018-January 2019) in January 2019 through January 2021 (prevaccine period) and February through May 2021 (vaccine period) were compared.The Wilson method was used to calculate 95% confidence intervals for single proportions. Change in incidence between periods and 95% confidence intervals for incidence were assessed using an exact rate ratio test assuming Poisson distribution, with a 2-sided P < .05 defining statistical significance. R version 2021 statistical software (R Foundation) was used. The Providence institutional review board approved the study with a waiver of informed consent.

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Section: Supplemental Contentmentioning

confidence: 99%

Myocarditis and Pericarditis After Vaccination for COVID-19

Diaz

Parsons

Gering

et al. 2021

JAMA

370

320

View full text Add to dashboard Cite

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“…Similarly, the European Medicines Agency (EMA) reports less than a thousand cases of myopericarditis up to June 2021 2 . The cases described in literature usually present with fever, chest pain, and dyspnea, together with changes on the electrocardiogram and cardiac magnetic resonance findings consistent with myocarditis; the symptoms usually resolved rapidly (114)(115)(116)(117)(118)(119)(120). The patients were treated with non-steroidal anti-inflammatory drugs (NSAIDs) only, but, in some cases, required intravenous immune globulin (IVIG) and corticosteroids (114)(115)(116)(117)(118)(119)(120).…”

Section: Cardiovascular Involvement After Covid-19 Vaccinationmentioning

confidence: 99%

“…The cases described in literature usually present with fever, chest pain, and dyspnea, together with changes on the electrocardiogram and cardiac magnetic resonance findings consistent with myocarditis; the symptoms usually resolved rapidly (114)(115)(116)(117)(118)(119)(120). The patients were treated with non-steroidal anti-inflammatory drugs (NSAIDs) only, but, in some cases, required intravenous immune globulin (IVIG) and corticosteroids (114)(115)(116)(117)(118)(119)(120). However, up-to-date, no causal relationship between vaccine administration and myocarditis has been established.…”

Section: Cardiovascular Involvement After Covid-19 Vaccinationmentioning

confidence: 99%

COVID-19 and Heart Failure: From Epidemiology During the Pandemic to Myocardial Injury, Myocarditis, and Heart Failure Sequelae

Italia

Tomasoni

Bisegna

et al. 2021

Front. Cardiovasc. Med.

106

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A close and intriguing relationship has been suggested between heart failure (HF) and coronavirus disease 2019 (COVID-19). First, COVID-19 pandemic represented a global public health emergency in the last year and had a catastrophic impact on health systems worldwide. Several studies showed a reduction in HF hospitalizations, ranging from 30 to 66% in different countries and leading to a subsequent increase in HF mortality. Second, pre-existing HF is a risk factor for a more severe clinical course of COVID-19 and an independent predictor of in-hospital mortality. Third, patients hospitalized for COVID-19 may develop both an acute decompensation of chronic HF and de-novo HF as a consequence of myocardial injury and cardiovascular (CV) complications. Myocardial injury occurred in at least 10% of unselected COVID-19 cases and up to 41% in critically ill patients or in those with concomitant CV comorbidities. Few cases of COVID-19-related acute myocarditis, presenting with severe reduction in the left ventricular (LV) ejection fraction and peculiar histopathological findings, were described. However, recent data suggested that COVID-19 may be associated with both systolic and diastolic LV dysfunction, with LV diastolic impairment, pulmonary hypertension, and right ventricular dysfunction representing the most frequent findings in echocardiographic studies. An overview of available data and the potential mechanisms behind myocardial injury, possibly leading to HF, will be presented in this review. Beyond the acute phase, HF as a possible long-term consequence of cardiac involvement in COVID-19 patients has been supposed and need to be investigated yet.

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“…Conversely, in the current era of heightened surveillance by the CDC's vaccine safety data (VSD) working group and the Vaccine Related Biological Products Advisory Committee (VRBPAC) on immunization practices after COVID-19, and postmarketing surveillance by the vaccine producing companies in the setting of conditional marketing authorization, the reporting of probable myocarditis and pericarditis cases is significantly higher. Since April 2021, increased cases of myocarditis and pericarditis have been reported in the United States after mRNA COVID-19 vaccination, particularly in adolescents and young adults [7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

Myocarditis and Pericarditis Following mRNA COVID-19 Vaccination: What Do We Know So Far?

et al. 2021

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This is a cross-sectional study of 29 published cases of acute myopericarditis following COVID-19 mRNA vaccination. The most common presentation was chest pain within 1–5 days after the second dose of mRNA COVID-19 vaccination. All patients had an elevated troponin. Cardiac magnetic resonance imaging revealed late gadolinium enhancement consistent with myocarditis in 69% of cases. All patients recovered clinically rapidly within 1–3 weeks. Most patients were treated with non-steroidal anti-inflammatory drugs for symptomatic relief, and 4 received intravenous immune globulin and corticosteroids. We speculate a possible causal relationship between vaccine administration and myocarditis. The data from our analysis confirms that all myocarditis and pericarditis cases are mild and resolve within a few days to few weeks. The bottom line is that the risk of cardiac complications among children and adults due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection far exceeds the minimal and rare risks of vaccination-related transient myocardial or pericardial inflammation.

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Myocarditis Temporally Associated With COVID-19 Vaccination

Abstract: Supplemental Digital Content is available in the text.

Cited by 195 publications

References 4 publications

Myocarditis and Pericarditis After Vaccination for COVID-19

Myocarditis and Pericarditis After Vaccination for COVID-19

COVID-19 and Heart Failure: From Epidemiology During the Pandemic to Myocardial Injury, Myocarditis, and Heart Failure Sequelae

Myocarditis and Pericarditis Following mRNA COVID-19 Vaccination: What Do We Know So Far?

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