A Systematic Review of Myocarditis Associated with Covid-19 Mrna Vaccination among Adolescents

Abstract

The COVID-19 infection which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can lead to severe respiratory illness especially in male adolescents. This systematic review article aimed to compile and illustrate clinical features, diagnostic findings, management, and outcomes manifesting in adolescents in myocarditis associated with mRNA Covid-19. A literature search was accomplished for published eligible articles with MEDLINE and PubMed. All eligible case reports and case series were included from around the world without any language restrictions. For this review, inclusion criteria were confirmed-confirmed SARS-CoV-2 infection cases reporting a diagnosis of myocarditis in adolescents. A total of 6 articles with a total number of 107 patients were included. Patients presented with fatigue, fever, headache, malaise and chest pain. The median age of these patients was 16.23 years. Cardiac biomarkers troponin was raised in almost 78.5% of patients. Elevated C-reactive protein levels were also reported in some of the patients. Electrocardiography results demonstrated ST-segment division while echocardiography showed normal in 4.67% of the studied patients and left ventricular systolic function in 3.74%. Hydroxychloroquine, antiviral therapy, corticosteroids, nonsteroidal anti-inflammatory drugs, intravenous immunoglobin, and glucocorticoids were the most frequent used medications with no death recorded. Common available data on COVID-19 myocarditis among adolescents is limited. Further research is therefore needed to advance the understanding of COVID-19 myocarditis among adolescents.