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Risks of Cardiac Arrhythmia Associated with COVID-19 Vaccination: A Systematic Review and Meta-Analysis

Mohammed H Abutaleb1, Hafiz A Makeen2, Abdulkarim M Meraya2

  • 1Pharmaceutical Care Department, King Fahad Central Hospital, Jazan Health Affairs, Ministry of Health, Jazan 82912, Saudi Arabia.

Vaccines
|January 21, 2023
PubMed

Insights

COVID-19 vaccination is rarely associated with cardiac arrhythmia, with incidence rates between 1-76 per 10,000. mRNA vaccines showed a higher risk compared to vector-based and inactivated vaccines.

Area of Science:

  • Cardiology
  • Vaccinology
  • Public Health

Background:

  • The widespread use of coronavirus disease 2019 (COVID-19) vaccines necessitates understanding their safety profiles.
  • Cardiac arrhythmia is a potential adverse event that requires thorough investigation following vaccination.

Purpose of the Study:

  • To systematically review and meta-analyze existing evidence on the association between COVID-19 vaccination and cardiac arrhythmia risk.
  • To compare the incidence of cardiac arrhythmia across different COVID-19 vaccine types.

Main Methods:

  • A systematic literature search was conducted across major databases (MEDLINE, Scopus, CENTRAL, Web of Science).
  • Seventeen studies encompassing over 567 million patients were included in the meta-analysis.
  • Statistical analyses were performed using Comprehensive Meta-analysis and Review Manager software.

Main Results:

  • The overall incidence of cardiac arrhythmia post-COVID-19 vaccination was rare, ranging from 1 to 76 per 10,000 individuals.
  • Messenger RNA (mRNA) vaccines (Pfizer, Moderna) demonstrated a higher incidence ratio rate (IRR) of arrhythmia compared to viral vector vaccines (AstraZeneca) and inactivated vaccines (CoronaVac, Sinopharm).
  • Specifically, Pfizer and Moderna showed significantly higher IRRs compared to CoronaVac and Sinopharm.

Conclusions:

  • COVID-19 vaccination is associated with a rare incidence of cardiac arrhythmia.
  • mRNA vaccines exhibit a higher incidence rate of cardiac arrhythmia compared to vector-based and inactivated vaccines.
  • Further research may be warranted to elucidate the mechanisms underlying these observed differences.

Keywords:
COVID-19arrhythmiaincidencemeta-analysisvaccine

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