Myocarditis Related to COVID-19 and SARS-CoV-2 Vaccination

Molina-Ramos, Ana Isabel; Gómez-Moyano, Elísabeth; Rodríguez-Capitán, Jorge; Angullo-Gómez, María; Gallardo-Jiménez, Patricia; Pedro, Iván Pérez de; Santis, Lucía Valiente de; Pérez-Villardón, Beatriz; Piñero-Uribe, Isabel; Mora-Robles, Javier; Becerra‐Muñoz, Víctor Manuel; Jiménez-Navarro, Manuel F.

doi:10.3390/jcm11236999

Cited by 6 publications

(4 citation statements)

References 43 publications

(104 reference statements)

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“…A central role of interferongamma affecting the mitogen-activated protein kinase (MAPK) and Janus kinase (JAK)-a signal transducer and activator of transcription (STAT) signalling pathways with adverse cardiac events-has been described [41]. The endothelial disturbance created by viral invasion and the circulating cytokines could promote the appearance of microvascular disease [42]. Endothelial cell biomarkers, including von Willebrand factor (vWF) antigen, vWF pro-peptide, and factor VIII, are significantly elevated in convalescent COVID-19, suggesting a persistent endotheliopathy [43].…”

Section: Post-acute Sequelae Of Covidmentioning

confidence: 99%

The Role of Heparin in Postural Orthostatic Tachycardia Syndrome and Other Post-Acute Sequelae of COVID-19

Gómez-Moyano,

Pavón-Morón,

Rodríguez-Capitán

et al. 2024

JCM

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The therapeutic management and short-term consequences of the coronavirus disease 2019 (COVID-19) are well known. However, COVID-19 post-acute sequelae are less known and represent a public health problem worldwide. Patients with COVID-19 who present post-acute sequelae may display immune dysregulation, a procoagulant state, and persistent microvascular endotheliopathy that could trigger microvascular thrombosis. These elements have also been implicated in the physiopathology of postural orthostatic tachycardia syndrome, a frequent sequela in post-COVID-19 patients. These mechanisms, directly associated with post-acute sequelae, might determine the thrombotic consequences of COVID-19 and the need for early anticoagulation therapy. In this context, heparin has several potential benefits, including immunomodulatory, anticoagulant, antiviral, pro-endothelial, and vascular effects, that could be helpful in the treatment of COVID-19 post-acute sequelae. In this article, we review the evidence surrounding the post-acute sequelae of COVID-19 and the potential benefits of the use of heparin, with a special focus on the treatment of postural orthostatic tachycardia syndrome.

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Section: Post-acute Sequelae Of Covidmentioning

confidence: 99%

The Role of Heparin in Postural Orthostatic Tachycardia Syndrome and Other Post-Acute Sequelae of COVID-19

Gómez-Moyano,

Pavón-Morón,

Rodríguez-Capitán

et al. 2024

JCM

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“…Vaccination with effective tools is crucial to control the COVID-19 pandemic and reduce its burden ( 30 ). However, severe adverse reactions have been reported following the COVID-19 vaccine, including myocarditis/pericarditis, thrombotic events, rare cases of arrhythmia, hypertension, acute coronary syndrome, and cardiac arrest ( 30 , 116 ).…”

Section: Pots and Vaccinationmentioning

confidence: 99%

Postural orthostatic tachycardia syndrome and other related dysautonomic disorders after SARS-CoV-2 infection and after COVID-19 messenger RNA vaccination

Gómez-Moyano,

Rodríguez-Capitán,

Gaitán Román

et al. 2023

Front. Neurol.

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The COVID-19 pandemic has caused a challenge for our society due to the post-acute sequelae of the disease. Persistent symptoms and long-term multiorgan complications, known as post-acute COVID-19 syndrome, can occur beyond 4 weeks from the onset of the COVID-19 infection. Postural orthostatic tachycardia syndrome (POTS) is considered a variety of dysautonomia, which is characterized by chronic symptoms that occur with standing and a sustained increase in heart rate, without orthostatic hypotension. POTS can lead to debilitating symptoms, significant disability, and impaired quality of life. In this narrative review, the etiopathogenic basis, epidemiology, clinical manifestations, diagnosis, treatment, prognosis, and socioeconomic impact of POTS, as well as other related dysautonomic disorders, after COVID-19 infection and SARS-CoV-2 postvaccination, were discussed. After a search conducted in March 2023, a total of 89 relevant articles were selected from the PubMed, Google Scholar, and Web of Science databases. The review highlights the importance of recognizing and managing POTS after COVID-19 infection and vaccination, and the approach to autonomic disorders should be known by all specialists in different medical areas. The diagnosis of POTS requires a comprehensive clinical assessment, including a detailed medical history, physical examination, orthostatic vital signs, and autonomic function tests. The treatment of POTS after COVID-19 infection or vaccination is mainly focused on lifestyle modifications, such as increased fluid and salt intake, exercise, and graduated compression stockings. Pharmacotherapy, such as beta-blockers, fludrocortisone, midodrine, and ivabradine, may also be used in selected cases. Further research is needed to understand the underlying mechanisms, risk factors, and optimal treatment strategies for this complication.

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“…The incidence of myocarditis following mRNA vaccination of COVID-19 is 56 to 69 cases per 1,000,000 in men and 8 to 10 per 1,000,000 in women [ 29 ] . In the United States and Israel, the overall incidence rate is 0.3 to 5.0 cases per 100,000 vaccinees [ 24 ] .…”

Section: Clinical Topic I Myocardial Injury Caused By Covid-19mentioning

confidence: 99%

“…Existing data suggest COVID-19 vaccination may lead to myocardial injury, myocarditis, and even fulminant myocarditis [ 56 ] . The estimated incidence of myocarditis associated with COVID-19 vaccination is 56–69 per million in men and 8–10 per million in women [ 29 ] . Based on the surveillance data from the United States, the incidence of myocarditis in people receiving two doses of mRNA vaccine (including Pfizer BNT162b2 and Moderna mRNA-1273) was 40.6 per million men aged 12–29 years, 4.2 per million women aged 12–29 years, 2.4 per million men aged 30 years and older, and 1.0 per million women aged 30 years and older.…”

Section: Clinical Topic I Myocardial Injury Caused By Covid-19mentioning

confidence: 99%

2023 Chinese expert consensus on the impact of COVID-19 on the management of cardiovascular diseases

2023

Cardiology Plus

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The primary site of infection in COVID-19 exhibit is the respiratory system, but multiple organ systems could be affected. The virus could directly invade cardiomyocytes. Alternatively, cytokine storm could lead to myocardial injury. More importantly, the management of existing cardiovascular diseases must be re-examined in COVID-19 due to, for example, interaction between antiviral agents and with a wide variety of pharmacological agents. The Branch of Cardiovascular Physicians of Chinese Medical Doctor Association organized a panel of experts in cardiovascular and related fields to discuss this important issue, and formulated the “2023 Chinese Expert Consensus on the Impact of COVID-19 on the Management of Cardiovascular Diseases.” The Consensus was drafted on the basis of systematic review of existing evidence and diagnosis and treatment experience, and covers three major aspects: myocardial injury caused by COVID-10 and COVID-19 vaccine, the impact of COVID-19 on patients with cardiovascular disease, and the impact of COVID-19 on the cardiovascular system of healthy people, and rehabilitation guidance recommendations. The Consensus involves 11 core clinical issues, including incidence, pathogenesis, clinical manifestations, treatment strategies, prognosis, and rehabilitation. It is our hope that this Consensus will provide a practical guidance to cardiologists in the management of cardiovascular diseases in the new era of COVID-19 pandemic.

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Myocarditis Related to COVID-19 and SARS-CoV-2 Vaccination

Cited by 6 publications

References 43 publications

The Role of Heparin in Postural Orthostatic Tachycardia Syndrome and Other Post-Acute Sequelae of COVID-19

The Role of Heparin in Postural Orthostatic Tachycardia Syndrome and Other Post-Acute Sequelae of COVID-19

Postural orthostatic tachycardia syndrome and other related dysautonomic disorders after SARS-CoV-2 infection and after COVID-19 messenger RNA vaccination

2023 Chinese expert consensus on the impact of COVID-19 on the management of cardiovascular diseases

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