Das Bibhuti B, Kohli Utkarsh, Ramachandran Preeti, Nguyen Hoang H, Greil Gerald, Hussain Tarique, Tandon Animesh, Kane Colin, Avula Sravani, Duru Chioma, Hede Sannya, Sharma Kavita, Chowdhury Devyani, Patel Sunil, Mercer Christopher, Chaudhuri Nita Ray, Patel Bhavi, Ang Jocelyn Y, Asmar Basim, Sanchez Joselito, Khan Danyal
Department of Pediatrics, Children's of Mississippi Heart Center, University of Mississippi Medical Center, Jackson, MS.
Division of Pediatric Cardiology, Department of Pediatrics, West Virginia University Children's Hospital and West Virginia University School of Medicine, Morgantown, WV.
J Pediatr. 2021 Nov;238:26-32.e1. doi: 10.1016/j.jpeds.2021.07.044. Epub 2021 Jul 30.
To characterize the clinical course and outcomes of children 12-18 years of age who developed probable myopericarditis after vaccination with the Pfizer-BioNTech (BNT162b2) coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccine.
A cross-sectional study of 25 children, aged 12-18 years, diagnosed with probable myopericarditis after COVID-19 mRNA vaccination as per the Centers for Disease Control and Prevention criteria for myopericarditis at 8 US centers between May 10, 2021, and June 20, 2021. We retrospectively collected the following data: demographics, severe acute respiratory syndrome coronavirus 2 virus detection or serologic testing, clinical manifestations, laboratory test results, imaging study results, treatment, and time to resolutions of symptoms.
Most (88%) cases followed the second dose of vaccine, and chest pain (100%) was the most common presenting symptom. Patients came to medical attention a median of 2 days (range, <1-20 days) after receipt of Pfizer mRNA COVID-19 vaccination. All adolescents had an elevated plasma troponin concentration. Echocardiographic abnormalities were infrequent, and 92% showed normal cardiac function at presentation. However, cardiac magnetic resonance imaging, obtained in 16 patients (64%), revealed that 15 (94%) had late gadolinium enhancement consistent with myopericarditis. Most were treated with ibuprofen or an equivalent nonsteroidal anti-inflammatory drug for symptomatic relief. One patient was given a corticosteroid orally after the initial administration of ibuprofen or an nonsteroidal anti-inflammatory drug; 2 patients also received intravenous immune globulin. Symptom resolution was observed within 7 days in all patients.
Our data suggest that symptoms owing to myopericarditis after the mRNA COVID-19 vaccination tend to be mild and transient. Approximately two-thirds of patients underwent cardiac magnetic resonance imaging, which revealed evidence of myocardial inflammation despite a lack of echocardiographic abnormalities.
描述12至18岁儿童在接种辉瑞-生物科技公司（BNT162b2）2019冠状病毒病（COVID-19）信使核糖核酸（mRNA）疫苗后发生可能的心肌心包炎的临床过程和结局。
一项横断面研究，研究对象为2021年5月10日至2021年6月20日期间在美国8个中心按照美国疾病控制与预防中心心肌心包炎标准被诊断为COVID-19 mRNA疫苗接种后可能发生心肌心包炎的25名12至18岁儿童。我们回顾性收集了以下数据：人口统计学资料、严重急性呼吸综合征冠状病毒2病毒检测或血清学检测结果、临床表现、实验室检查结果、影像学检查结果、治疗情况以及症状缓解时间。
大多数（88%）病例在接种第二剂疫苗后发病，胸痛（100%）是最常见的首发症状。患者在接种辉瑞mRNA COVID-19疫苗后中位2天（范围：<1至20天）前来就医。所有青少年血浆肌钙蛋白浓度均升高。超声心动图异常情况不常见，92%的患者就诊时心脏功能正常。然而，16例患者（64%）接受了心脏磁共振成像检查，其中15例（94%）显示钆延迟强化，符合心肌心包炎表现。大多数患者接受布洛芬或等效的非甾体抗炎药治疗以缓解症状。1例患者在最初使用布洛芬或非甾体抗炎药后口服了皮质类固醇；2例患者还接受了静脉注射免疫球蛋白治疗。所有患者在7天内症状均得到缓解。
我们的数据表明，COVID-19 mRNA疫苗接种后心肌心包炎所致症状往往较轻且为一过性。约三分之二的患者接受了心脏磁共振成像检查，尽管超声心动图无异常，但检查结果显示存在心肌炎症证据。
