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Review
. 2022 Dec;24(12):2031-2041.
doi: 10.1007/s11886-022-01801-6. Epub 2022 Nov 28.

COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation

Muhammad Furqan  1 , Sanchit Chawla  1 , Muhammad Majid  2 , Samia Mazumdar  2 , Gauranga Mahalwar  2 , Evan Harmon  2 , Allan Klein  3
Affiliations
Review

COVID-19 Vaccine-Related Myocardial and Pericardial Inflammation

Muhammad Furqan et al. Curr Cardiol Rep. 2022 Dec.

Abstract

Purpose of review: To review myocarditis and pericarditis developing after COVID-19 vaccinations and identify the management strategies.

Recent findings: COVID-19 mRNA vaccines are safe and effective. Systemic side effects of the vaccines are usually mild and transient. The incidence of acute myocarditis/pericarditis following COVID-19 vaccination is extremely low and ranges 2-20 per 100,000. The absolute number of myocarditis events is 1-10 per million after COVID-19 vaccination as compared to 40 per million after a COVID-19 infection. Higher rates are reported for pericarditis and myocarditis in COVID-19 infection as compared to COVID-19 vaccines. COVID-19 vaccine-related inflammatory heart conditions are transient and self-limiting in most cases. Patients present with chest pain, shortness of breath, and fever. Most patients have elevated cardiac enzymes and diffuse ST-segment elevation on electrocardiogram. Presence of myocardial edema on T2 mapping and evidence of late gadolinium enhancement on cardiac magnetic resonance imaging are also helpful additional findings. Patients were treated with non-steroidal anti-inflammatory drugs and colchicine with corticosteroids reserved for refractory cases. At least 3-6 months of exercise abstinence is recommended in athletes diagnosed with vaccine-related myocarditis. COVID-19 vaccination is recommended in all age groups for the overall benefits of preventing hospitalizations and severe COVID-19 infection sequela.

Keywords: COVID-19 vaccination; Myocarditis; Myopericarditis; Pericarditis; SARS-CoV-2.

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Conflict of interest statement

Dr. Klein has received a research grant from and is a scientific advisory board member for Kiniksa Pharmaceuticals; and is a scientific advisory board member for Swedish Orphan Biovitrum, Sweden, Pfizer, USA, and Cardiol Therapeutics; and he has a leadership or fiduciary role on the National Board of Echocardiography. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

Fig. 1
Fig. 1
Mechanism of action of COVID vaccines and development of myopericarditis
See this image and copyright information in PMC

References

    1. Tschöpe C, Ammirati E, Bozkurt B, Caforio ALP, Cooper LT, Felix SB, et al. Myocarditis and inflammatory cardiomyopathy: current evidence and future directions. Nat Rev Cardiol. 2020 183 [Internet]. Nature Publishing Group; 2020 [cited 2022 Aug 29];18:169–93. Available from: https://www.nature.com/articles/s41569-020-00435-x. - PMC - PubMed
    1. Fairweather DL, Cooper LT, Blauwet LA. Sex and gender differences in myocarditis and dilated cardiomyopathy. Curr Probl Cardiol [Internet]. Curr Probl Cardiol. 2013 [cited 2022 Aug 29];38:7–46. Available from: https://pubmed.ncbi.nlm.nih.gov/23158412/. - PMC - PubMed
    1. Prepoudis A, Koechlin L, Nestelberger T, Boeddinghaus J, Lopez-Ayala P, Wussler D, et al. Incidence, clinical presentation, management, and outcome of acute pericarditis and myopericarditis. Eur Hear Journal Acute Cardiovasc Care [Internet]. Oxford Academic; 2022 [cited 2022 Aug 29];11:137–47. Available from: https://academic.oup.com/ehjacc/article/11/2/137/6445206. - PubMed
    1. Lota AS, Halliday B, Tayal U, Salmi S, Shakur R, Hammersley D, et al. Epidemiological trends and outcomes of acute myocarditis in the National Health Service of England | Circulation. AHA [Internet]. 2019 [cited 2022 Sep 2];140. Available from: https://www.ahajournals.org/doi/10.1161/circ.140.suppl_1.11463. - DOI
    1. Su JR, McNeil MM, Welsh KJ, Marquez PL, Ng C, Yan M, et al. Myopericarditis after vaccination, Vaccine Adverse Event Reporting System (VAERS), 1990–2018. Vaccine [Internet]. Vaccine. 2021 [cited 2022 Aug 29];39:839–45. Available from: https://pubmed.ncbi.nlm.nih.gov/33422381/. - PubMed