COVID-19 Vaccine-Related Myocarditis: A Descriptive Study of 40 Case Reports

Abstract

After the surging rise in the Coronavirus disease 2019 (COVID-19) pandemic, the Food and Drug Administration (FDA) approved emergency approval of vaccinations to prevent life-threatening complications of COVID-19 infection. These vaccines are BNT162b2, mRNA-1273. Later, the FDA also approved JNJ-78436735. COVID-19 vaccination does not have major side effects, but there are some concerning adverse events reported right after vaccination. Myocarditis is one of them. Based on our analysis of 40 case reports, we are presenting the epidemiology and clinical picture of myocarditis related to the COVID-19 vaccine.Based on our analysis, we found that the majority of cases were seen in males with 90% predominance, and these cases were seen in the age group of 29.13 years old (mean, SD of 14.39 years). In 65% of cases, patients took the BNT162b2 vaccine; 30% of cases were reported with the mRNA-1273 vaccine; and 5% of cases with JNJ-78436735. Of all the cases, 80% of them are reported after the second dose of the vaccine with either Moderna or Pfizer.The characteristics of COVID-19 vaccine-related myocarditis were analyzed in this study. We identified several findings, ranging from age, gender, type of vaccination, presentation of symptoms, and diagnosis modality. This depicts the picture of COVID-19 vaccine-related myocarditis and what physicians should expect when dealing with the disease. Our analysis showed that more cases were reported after receiving the BNT162b2 vaccine compared to mRNA-1273 and JNJ-78436735 vaccines. Further research needs to be conducted to analyze the underlying cause of this association.

Cardiac MRI Findings in COVID‐19 Vaccine‐Related Myocarditis: A Pooled Analysis of 468 Patients

“…Overall, 266 publications were retrieved for review of full‐text articles. Finally, 102 publications, including 56 case reports 12 , 13 , 14 , 15 , 16 , 17 , 18 , 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 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 92 , 93 , 94 , 97 , 98 , 101 , 102 , 105 , 106 an...…”

“…A total of 468 patients with suspected myocarditis and cardiac MRI findings were included in this study ( n = 294 from case reports/case series with IPD 5 , 7 , 9 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 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 , …”

“…Overall, 266 publications were retrieved for review of full‐text articles. Finally, 102 publications, including 56 case reports 12–50,52–58,92–94,97,98,101,102,105,106 and 46 case series 5,7,10,23,35,45,51,59–91,95,96,100,103,104,107 fulfilled the inclusion criteria. Figure 1 shows the selection process in detail.…”

“… 5 An increasing number of studies have utilized cardiac MRI, as the most important noninvasive diagnostic tool, to assess suspected myocarditis associated with COVID‐19 vaccination. 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 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 , …”

Myocarditis Following COVID-19 Vaccine Use: Can It Play a Role for Conditioning Immunization Schedules?

“…However, due to the milder clinical course compared to classic MYO and MIS-C MYO, strong pharmacologic support is only rarely required in patients with COVID-19 vaccine-related MYO. Use of non-steroidal anti-inflammatory drugs, immune globulin (IVIG), and steroids is not common ( 48 ) and remains controversial ( 49 ). A pediatric study comparing drug use in patients with viral MYO, MIS-C MYO and vaccine-related MYO has shown that intravenous immunoglobulin (IVIG) and steroids were frequently used in patients with classic MYO and MIS-C MYO but in only one and in none of the 9 patients with previous COVID-19 immunization ( 50 ).…”