Department of Cardiology, National University Heart Centre, Singapore, Singapore.
Yong Loo Lin School of Medicine. Singapore 117597.
QJM. 2023 Apr 29;116(4):279-283. doi: 10.1093/qjmed/hcab252.
Emerging reports raise concerns on the potential association between the COVID-19 vaccines and cardiac manifestations. We sought to evaluate cardiac complications associated with COVID-19 vaccination in a pooled analysis from our institution's cohort study and systematic review. Consecutive patients admitted to a tertiary hospital in Singapore between 1 January 2021 and 31 March 2021, with the onset of cardiac manifestations within 14 days following COVID-19 vaccination, were studied. Furthermore, a systematic review was performed, with PubMed, Embase, Research Square, MedRxiv and LitCovid databases accessed from inception up to 29 June 2021. Relevant manuscripts reporting individual patient data on cardiac complications following COVID-19 vaccination were included. Thirty patients were included in the study cohort, with 29 diagnosed with acute myocardial infarction (AMI) and 1 with myocarditis. Five patients developed heart failure, two had cardiogenic shock, three intubated, and one had cardiovascular-related mortality. In the systematic review, 16 studies were included with 41 myocarditis and 6 AMI cases. In the pooled analysis of the study cohort and the systematic review, 35 patients had AMI and 42 had myocarditis. Majority were men, and myocarditis patients were younger than AMI patients. Myocarditis patients tended to present 72 h postvaccination, while AMI patients were older and typically presented 24 h postvaccination. Majority with AMI or myocarditis developed symptoms after the first and second vaccination dose, respectively. This pooled analysis of patients presenting with cardiac manifestations following COVID-19 vaccination highlights the differences between myocarditis and AMI presentations in temporal association with the vaccination.
新出现的报告引起了人们对 COVID-19 疫苗与心脏表现之间潜在关联的关注。我们试图通过对我院队列研究和系统评价的数据进行汇总分析，评估与 COVID-19 疫苗接种相关的心脏并发症。连续纳入 2021 年 1 月 1 日至 3 月 31 日期间在新加坡一家三级医院住院、接种 COVID-19 疫苗后 14 天内出现心脏表现的患者。此外，还进行了系统评价，检索了从建库至 2021 年 6 月 29 日的 PubMed、Embase、Research Square、MedRxiv 和 LitCovid 数据库。纳入报告 COVID-19 疫苗接种后心脏并发症的个体患者数据的相关文献。研究队列包括 30 例患者，其中 29 例诊断为急性心肌梗死（AMI），1 例为心肌炎。5 例发生心力衰竭，2 例发生心源性休克，3 例需要插管，1 例发生心血管相关死亡。在系统评价中，纳入了 16 项研究，包括 41 例心肌炎和 6 例 AMI 病例。在研究队列和系统评价的汇总分析中，有 35 例患者发生 AMI，42 例患者发生心肌炎。大多数是男性，心肌炎患者比 AMI 患者年轻。心肌炎患者倾向于在接种后 72 小时出现症状，而 AMI 患者年龄较大，通常在接种后 24 小时出现症状。大多数 AMI 或心肌炎患者分别在接种第一剂和第二剂后出现症状。这项汇总分析强调了 COVID-19 疫苗接种后出现心脏表现的患者中，心肌炎和 AMI 表现与接种时间的差异。
