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COVID-19 vaccination-related myocarditis: a Korean nationwide study

Jae Yeong Cho1,2, Kye Hun Kim1,2, Nuri Lee2,3

  • 1Department of Cardiovascular Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Korea.

European Heart Journal
|June 2, 2023
PubMed

Insights

COVID-19 vaccination-related myocarditis (VRM) is rare, affecting 1.08 per 100,000 individuals, with higher incidence in males and mRNA vaccines. Severe cases, including sudden cardiac death, require monitoring.

Area of Science:

  • Cardiology
  • Immunology
  • Public Health

Background:

  • Myocarditis following COVID-19 vaccination (VRM) necessitates comprehensive incidence and outcome analysis.
  • Understanding VRM risk factors and clinical trajectories is crucial for public health strategies.

Purpose of the Study:

  • To conduct a nationwide study on the incidence and outcomes of COVID-19 vaccination-related myocarditis (VRM).
  • To analyze demographic and vaccine-specific risk factors for VRM.
  • To assess the clinical course and severity of confirmed VRM cases.

Main Methods:

  • Analysis of 44,276,704 individuals receiving at least one COVID-19 vaccine dose.
  • Confirmation of VRM cases by the Korea Disease Control and Prevention Agency's Expert Adjudication Committee.
  • Incidence and outcome data stratified by sex, age, and vaccine type.

Main Results:

  • VRM incidence was 1.08 cases per 100,000 persons, significantly higher in males (1.35/100,000) and with mRNA vaccines (1.46/100,000).
  • Highest incidence observed in males aged 12-17 years (5.29/100,000); lowest in females over 70 (0.16/100,000).
  • Severe VRM occurred in 19.8% of cases, including 7.5% fulminant myocarditis and 4.4% deaths, with 4.4% experiencing sudden cardiac death, particularly in younger males receiving mRNA vaccines.

Conclusions:

  • COVID-19 VRM is rare but can present with severe outcomes in a subset of cases.
  • Sudden cardiac death is a critical, potentially fatal complication of VRM, warranting close surveillance.
  • Public health efforts should focus on monitoring and managing VRM, especially in high-risk demographics and following mRNA vaccination.
Abstract

Keywords:
COVID-19MyocarditisOutcomesVaccination

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