Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Tufts Medical Center, Tufts University, Boston, Massachusetts.
Am J Cardiol. 2022 Feb 1;164:123-130. doi: 10.1016/j.amjcard.2021.10.022. Epub 2021 Nov 28.
Several recent publications have described myopericarditis cases after the coronavirus disease 2019 (COVID-19) vaccination. However, it is uncertain if these cases occurred secondary to the vaccination or more common etiologies of myopericarditis. To help determine whether a correlation exists between COVID-19 vaccination and myopericarditis, the present study compared the gender-specific cumulative incidence of myopericarditis and myocardial injury in a cohort of COVID-19 vaccinated patients at a tertiary care center in 2021 with the cumulative incidence of these conditions in the same subjects exactly 2 years earlier. We found that the age-adjusted incidence rate of myopericarditis in men was higher in the vaccinated than the control population, rate ratio 9.7 (p = 0.04). However, the age-adjusted incidence rate of myopericarditis in women was no different between the vaccinated and control populations, rate ratio 1.28 (p = 0.71). We further found that the rate of myocardial injury was higher in both men and women in 2021 than in 2019 both before and after vaccination, suggesting that some of the apparent increase in the diagnosis of myopericarditis after vaccination may be attributable to factors unrelated to the COVID-19 vaccinations. In conclusion, our study reaffirms the apparent increase in the diagnosis of myopericarditis after COVID-19 vaccination in men but not in women, although this finding may be confounded by increased rates of myocardial injury in 2021. The benefits of COVID-19 vaccination to individual and public health clearly outweigh the small potential increased risk of myopericarditis after vaccination.
几项最近的出版物描述了 COVID-19（新冠肺炎）疫苗接种后的心肌炎病例。然而，这些病例是否是由疫苗接种引起的，还是更常见的心肌炎病因，尚不确定。为了帮助确定 COVID-19 疫苗接种与心肌炎之间是否存在相关性，本研究比较了 2021 年一家三级保健中心 COVID-19 接种患者队列中心肌炎和心肌损伤的性别特异性累积发病率与 2 年前同一患者的这些情况的累积发病率。我们发现，接种组男性心肌炎的年龄调整发病率高于对照组，比率比为 9.7（p=0.04）。然而，接种组和对照组女性心肌炎的年龄调整发病率无差异，比率比为 1.28（p=0.71）。我们进一步发现，2021 年男性和女性的心肌损伤发生率均高于 2019 年，无论是否接种疫苗，这表明接种疫苗后心肌炎诊断的明显增加可能归因于与 COVID-19 疫苗接种无关的因素。总之，我们的研究再次证实了 COVID-19 疫苗接种后男性心肌炎诊断的明显增加，但女性则不然，尽管这一发现可能受到 2021 年心肌损伤发生率增加的影响。COVID-19 疫苗接种对个人和公共健康的益处显然超过了接种后心肌炎潜在的小风险增加。
