Nitz James N, Ruprecht Kylie K, Henjum Lukas J, Matta Andrew Y, Shiferaw Barnabas T, Weber Zoie L, Jones Jalon M, May Raven, Baio Carmen J, Fiala Kenneth J, Abd-Elsayed Alaa A
Department of Anesthesiology, University of Wisconsin School of Medicine and Public Health, Madison, USA.
Department of Anesthesiology, Loyola University Parkinson School of Health Sciences, Madison, USA.
Cureus. 2025 Apr 10;17(4):e82041. doi: 10.7759/cureus.82041. eCollection 2025 Apr.
Vaccines against COVID-19 present a key tool in lowering the morbidity, mortality, and transmission of the disease, but they also present a strongly controversial topic. As a result, the adverse effects of the vaccine have been under scrutiny by the public eye. A comprehensive summary of the cardiovascular (CV) adverse effects of COVID-19 vaccines is vital for clinical recognition of rare adverse events, determining the public health implications, and creating a base for future research. In May 2023, a search was conducted in the PubMed and Cochrane databases to identify literature on CV complications resulting from the COVID-19 vaccine. All articles with relevant data and discussion regarding adverse effects of the COVID-19 vaccines were included in the review. In total, 4419 articles were screened, and 166 articles were included in the review. The vaccine-associated CV adverse events encompassed the following conditions: myocarditis, pericarditis, acute coronary syndrome, stress cardiomyopathy, hypertension, isolated tachycardia, myocardial infarction (MI) with nonobstructive coronary arteries (MINOCA), cardiac arrest, vaccine-induced thrombotic thrombocytopenia (VITT), MI, cerebral venous thrombosis (CVT), deep vein thrombosis (DVT), pulmonary embolism (PE), and other venous thrombotic disorders. Among these, myocarditis and thrombosis, especially VITT, emerged as the most frequently cited complications in the reviewed literature. Ranges of incidences for the following were recorded among the reviewed articles: myocarditis: 2 to 17 per million, VITT: 3-10 per million, CVST: 2.6-10 per million, MI: 3-4 per million. COVID-19 vaccines entail the potential for adverse events, although at low incidence, some of which exhibit notable severity. These adverse events exhibit demographic specificity and vaccine-specific profiles. The adverse events reviewed are uniformly acute in nature. The existing body of evidence offers limited support for the assertion that COVID-19 vaccines may elevate the baseline risk of CV events in the long term. However, the available research on effects greater than six months is scarce.
新冠疫苗是降低该疾病发病率、死亡率和传播率的关键工具,但它也是一个极具争议的话题。因此,疫苗的不良反应一直受到公众的密切关注。全面总结新冠疫苗的心血管不良反应对于临床识别罕见不良事件、确定其对公共卫生的影响以及为未来研究奠定基础至关重要。2023年5月,在PubMed和Cochrane数据库中进行了检索,以查找有关新冠疫苗导致心血管并发症的文献。所有包含新冠疫苗不良反应相关数据和讨论的文章均纳入本综述。总共筛选了4419篇文章,其中166篇被纳入综述。与疫苗相关的心血管不良事件包括以下情况:心肌炎、心包炎、急性冠状动脉综合征、应激性心肌病、高血压、单纯性心动过速、非阻塞性冠状动脉心肌梗死(MINOCA)、心脏骤停、疫苗诱导的血栓性血小板减少症(VITT)、心肌梗死、脑静脉血栓形成(CVT)、深静脉血栓形成(DVT)、肺栓塞(PE)以及其他静脉血栓性疾病。其中,心肌炎和血栓形成,尤其是VITT,是综述文献中最常被提及的并发症。在综述文章中记录了以下各项的发病率范围:心肌炎:每百万例2至17例,VITT:每百万例3至10例,CVST:每百万例2.6至10例,心肌梗死:每百万例3至4例。新冠疫苗存在发生不良事件的可能性,尽管发生率较低,但其中一些不良事件的严重程度值得关注。这些不良事件具有人口统计学特异性和疫苗特异性特征。所综述的不良事件本质上均为急性。现有证据对新冠疫苗可能长期提高心血管事件基线风险这一说法的支持有限。然而,关于超过六个月影响的现有研究很少。