Matta Abhishek, Kunadharaju Rajesh, Osman Marcus, Jesme Christy, McMiller Zachary, Johnson Erika M, Matta Danielle, Kallamadi Rekha, Bande Dinesh
Internal Medicine, Sanford Health, Fargo, USA.
Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, USA.
Cureus. 2021 Nov 3;13(11):e19240. doi: 10.7759/cureus.19240. eCollection 2021 Nov.
Myocarditis is being increasingly reported as a potential complication of both Pfizer-BioNTech and Moderna vaccines for COVID-19. One thousand five hundred and twenty-two cases were reported as of September 02, 2021, as per CDC's (Centers for Disease Control) vaccine adverse event reporting system. Most of the published data is available in the form of case reports and series. There is a need to compile the demographic data, clinical features, and outcomes in these patients. Methods: A systematic search was conducted in PubMed, Embase, Web of science, and google scholar for published literature between January 01, 2020, and July 17, 2021. Individual data of 69 patients were pooled from 25 qualifying case reports and case series.
The median age of onset was 21 years. 92.7% of the patients were male. 76.8% of patients received the Pfizer-BioNTech vaccine, and 23.2% received the Moderna vaccine. 88.5% developed symptoms after the second dose. Patients were admitted to the hospital a median of three days post-vaccination. All the patients had chest pain and elevated troponin. The myocarditis was confirmed on cardiac MRI in 87% of the patients. Most of the patients had late gadolinium enhancement on MRI. The median length of stay was four days. All the reported patients recovered and were discharged.
Post-mRNA vaccination myocarditis is seen predominantly in young males within a few days after their second dose of vaccination. The pathophysiology of myocarditis is not well known. The prognosis is good as all the reported patients recovered. The presence of late gadolinium enhancement on cardiac MRI indicated myocardial necrosis/fibrosis and further studies are needed to establish the long-term prognosis of the condition.
越来越多的报告指出，辉瑞-生物科技公司和莫德纳公司的新冠疫苗都可能引发心肌炎这一潜在并发症。根据美国疾病控制与预防中心（CDC）的疫苗不良事件报告系统，截至2021年9月2日，共报告了1522例病例。大多数已发表的数据都是以病例报告和病例系列的形式呈现。有必要汇总这些患者的人口统计学数据、临床特征和预后情况。
在PubMed、Embase、科学网和谷歌学术上对2020年1月1日至2021年7月17日期间发表的文献进行系统检索。从25篇符合条件的病例报告和病例系列中汇总了69例患者的个体数据。
发病的中位年龄为21岁。92.7%的患者为男性。76.8%的患者接种了辉瑞-生物科技公司的疫苗，23.2%的患者接种了莫德纳公司的疫苗。88.5%的患者在接种第二剂疫苗后出现症状。患者在接种疫苗后中位三天入院。所有患者均有胸痛和肌钙蛋白升高。87%的患者通过心脏磁共振成像（MRI）确诊为心肌炎。大多数患者在MRI上有晚期钆增强。中位住院时间为四天。所有报告的患者均康复出院。
mRNA疫苗接种后心肌炎主要发生在年轻男性中，在接种第二剂疫苗后的几天内出现。心肌炎的病理生理学尚不清楚。由于所有报告的患者均康复，预后良好。心脏MRI上出现晚期钆增强表明心肌坏死/纤维化，需要进一步研究以确定该疾病的长期预后。
