Clinical characteristics and prognostic factors of myocarditis associated with the mRNA COVID-19 vaccine.
Por:
Woo W, Kim AY, Yon DK, Lee SW, Hwang J, Jacob L., Koyanagi A, Kim MS, Moon DH, Jung JW, Choi JY, Jung SY, Eun LY, Lee S, Shin JI and Smith L
Publicada:
1 abr 2022
Ahead of Print:
14 dic 2021
Resumen:
To analyze the clinical presentation and outcomes of myocarditis after administration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccine. Nine case series and 15 case reports (74 patients) of myocarditis after administration of the BNT162b2 or mRNA-1273 vaccine were reviewed from PubMed, Scopus, Embase, and Web of Science. We analyzed clinical manifestations, diagnostic findings, and outcomes. In addition, we performed a pooled analysis and investigated risk factors leading to admission to the intensive care unit and recovery with conservative care. Most patients were male (94.6%), and the median age (range) was 17.6 (14-70) years. Patients who received the BNT162b2 (n = 58, 78.4%) vaccine presented fewer systemic symptoms and left ventricular dysfunction than mRNA-1273 recipients. Although patients under 20 years experienced more fever and myalgia, they had better ejection fraction and less prominent myocardial inflammation in magnetic resonance imaging than older patients. The clinical course of all patients was favorable without mortality, and one-third of patients resolved with conservative care alone. Risk factor analyses revealed that patients with gastrointestinal symptoms required intensive care (odds ratio: 20.3, 95% confidence interval 1.90-217, p = 0.013). The risk of fatality in myocarditis subjected to mRNA vaccination seems to be low. However, patients with gastrointestinal symptoms received more intensive care, and a significant proportion of patients recovered with conservative management.
Filiaciones:
Woo W:
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Kim AY:
Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
Yon DK:
Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
Lee SW:
Department of Data Science, Sejong University College of Software Convergence, Seoul, South Korea
Hwang J:
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
Jacob L.:
Parc Sanitari Sant Joan de Deu/CIBERSAM, Universitat de Barcelona, Fundacio Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, Spain
Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
Koyanagi A:
Parc Sanitari Sant Joan de Deu/CIBERSAM, Universitat de Barcelona, Fundacio Sant Joan de Deu, Sant Boi de Llobregat, Barcelona, Spain
ICREA, Pg. Lluís Companys 23, Barcelona, Spain
Kim MS:
Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Samsung Medical Center, Seoul, Republic of Korea
Moon DH:
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Jung JW:
Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
Choi JY:
Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
Jung SY:
Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
Eun LY:
Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
Lee S:
Department of Thoracic and Cardiovascular Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Shin JI:
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea
Smith L:
Cambridge Centre for Health, Performance, and Wellbeing, Anglia Ruskin University, Cambridge, UK
Green Accepted, Green Published, Bronze
|