Case Report: Myocarditis After COVID-19 Vaccination – Case Series and Literature Review

Abstract

BackgroundThe ongoing COVID-19 pandemic demands a series of measures and, above all, the vaccination of a substantial proportion of the population. Acute myocarditis is a rare complication of the widely used mRNA-based vaccines.Case PresentationWe present a case series of four patients (three men and one woman, 16 to 47 years old) with acute pericarditis/myocarditis 3 to 17 days after mRNA vaccination. They presented with chest pain, fever, and flu-like symptoms. Diagnosis was made based on the synopsis of clinical presentation, elevated levels of troponin T and NT-proBNP, impaired systolic function on echocardiography, and findings in non-invasive tissue characterization by cardiovascular magnetic resonance imaging. Two patients also underwent endomyocardial biopsies. As none of the patients showed signs of cardiogenic shock, they were discharged from ward care only a few days after their initial presentations.ConclusionsOur data are consistent with other case reports of myocarditis early after mRNA vaccination and demonstrate the need for multimodal diagnostics. In view of its rarity and mild course, the risk–benefit ratio of vaccination remains positive compared to potential SARS-CoV-2 infection.

Immunization-associated myocarditis post mRNA COVID-19 vaccination: a review article

“…Furthermore, out of 50 hospitalized patients that took part in this review, only 3 were female (6%) and 47 patients were male (94%). Therefore, there seems to be a predisposition to suffer from vaccine-related myocarditis in males among this population dataset (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Furthermore, the mean age was 25.6 years old, the mode was 23 years old, and the median age was 24.5 years old.…”

“…Thus, vaccinationassociated myocarditis tends to affect more young adults in general. Additionally, 77.5% of cases started presenting symptoms of myocarditis after receiving the 2 nd dose, whereas patients who received the 1 st dose (20.4%) started having symptoms such as chest pain and fever, and there was only one patient who had the 3 rd dose (2.04%) and began noticing some adverse effects (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Hence, most people are more propense to start developing symptoms for myocarditis after taking the 2 nd dose of the COVID-19 vaccine.…”

“…Treatment for myocarditis included medication to improve the heart function; patients were treated with beta-blockers, non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroids drugs. Some other therapeutic treatment options were ACE inhibitors, angiotensin-converting enzyme inhibitor, omeprazole, bisoprolol, ramipril and activity restriction was also recommended (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Even though prognosis is good with majority of patients have been recovered in a few days after hospital admission (96%), only 2 patients died (4%).…”

“…On average, it takes approximately 4 days for patients to start showing symptoms of myocarditis after vaccination. In addition, hospitalized patients often had the following symptoms: chest pain, fever, palpitations, fatigue, and dyspnea (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). Moreover, PCR tests were performed and all of them were negative for SARS-COV-2 in all patients that took part in this review.…”

Clinical Characteristics of Patients with Myocarditis following COVID-19 mRNA Vaccination: A Systematic Review and Meta-Analysis

“…The initial search yielded 268 potentially relevant articles from which 75 unique studies involving 188 patients met eligibility criteria [ 16 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 ,…”