Myocarditis post-SARS-CoV-2 vaccination: a systematic review.
M Goyal1, I Ray2, D Mascarenhas1
1From the Department of Neonatology, Seth GSMC & KEMH, Acharya Donde Marg, Parel East, Parel, Mumbai, Maharashtra 400012, India.
QJM : Monthly Journal of the Association of Physicians
|March 3, 2022
Summary
Myocarditis after COVID-19 vaccination is typically mild, predominantly affecting young males and resolving quickly with conservative treatment. This highlights the need for standardized myocarditis definitions and treatment guidelines.
Area of Science:
- Cardiology
- Vaccinology
- Public Health
Background:
- Myocarditis following coronavirus disease 2019 (COVID-19) vaccination presents with variable clinical criteria and treatment approaches globally.
- A systematic review was necessary to understand the clinical characteristics, diagnostic parameters, therapeutic interventions, and outcomes of post-COVID-19 vaccination myocarditis.
Approach:
- A systematic review was conducted, analyzing 85 articles comprising 2184 patients diagnosed with myocarditis post-COVID-19 vaccination.
- Data were extracted from electronic databases including MEDLINE, EMBASE, PubMed, and Web of Science.
- PROSPERO registration ensured systematic and transparent methodology.
Key Points:
- The study population was predominantly young males (73.4%, mean age 25.5 years), with 99.4% receiving mRNA vaccines.
- Common symptoms included chest pain (90.1%), dyspnea (25.7%), and fever (11.9%), with elevated CRP (83.3%) and troponin (97.6%) observed.
- Treatment primarily involved NSAIDs (76.5%), steroids (14.1%), and colchicine (7.3%), with a low mortality rate (0.46%).
Conclusions:
- Myocarditis post-COVID-19 vaccination is generally mild, frequently observed in young, healthy males, and typically resolves rapidly with conservative management.
- The findings underscore the need for harmonized case definitions and definitive treatment guidelines for this adverse event.
- Further research is recommended to refine understanding and management strategies for vaccine-associated myocarditis.
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