Clinical characteristics and prognostic factors of myocarditis associated with the mRNA COVID-19 vaccine

Woo, Wongi, Kim, Ah Young, Yon, Dong Keon, Lee, Seung Won, Hwang, Jimin, Jacob, Louis, Koyanagi, Ai, Kim, Min Seo, Moon, Duk Hwan, Jung, Jo Won, Choi, Jae Young, Jung, Se Young, Eun, Lucy Youngmin, Lee, Sungsoo, Shin, Jae Il and Smith, Lee (2022) Clinical characteristics and prognostic factors of myocarditis associated with the mRNA COVID-19 vaccine. Journal of Medical Virology, 94 (4). pp. 1566-1580. ISSN 1096-9071

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Official URL: https://doi.org/10.1002/jmv.27501

Abstract

To analyze the clinical presentation and outcomes of myocarditis after administration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccine. Nine case series and 15 case reports (74 patients) of myocarditis after administration of the BNT162b2 or mRNA-1273 vaccine were reviewed from PubMed, Scopus, Embase, and Web of Science. We analyzed clinical manifestations, diagnostic findings, and outcomes. In addition, we performed a pooled analysis and investigated risk factors leading to admission to the intensive care unit and recovery with conservative care. Most patients were male (94.6%), and the median age (range) was 17.6 (14–70) years. Patients who received the BNT162b2 (n = 58, 78.4%) vaccine presented fewer systemic symptoms and left ventricular dysfunction than mRNA-1273 recipients. Although patients under 20 years experienced more fever and myalgia, they had better ejection fraction and less prominent myocardial inflammation in magnetic resonance imaging than older patients. The clinical course of all patients was favorable without mortality, and one-third of patients resolved with conservative care alone. Risk factor analyses revealed that patients with gastrointestinal symptoms required intensive care (odds ratio: 20.3, 95% confidence interval 1.90–217, p = 0.013). The risk of fatality in myocarditis subjected to mRNA vaccination seems to be low. However, patients with gastrointestinal symptoms received more intensive care, and a significant proportion of patients recovered with conservative management.

Item Type: Journal Article
Keywords: vaccine-induced myocarditis, covid-19, mRNA-1273, BNT162b2, COVID-19 vaccine, myocarditis
Faculty: COVID-19 Research Collection
Faculty of Science & Engineering
SWORD Depositor: Symplectic User
Depositing User: Symplectic User
Date Deposited: 02 Dec 2021 16:37
Last Modified: 13 Jun 2022 13:39
URI: https://arro.anglia.ac.uk/id/eprint/707144

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