Myocarditis in SARS-CoV-2: A Meta-Analysis.

Area of Science:

• Cardiology
• Infectious Diseases
• Vaccinology
• Epidemiology

Background:

• A notable increase in cardiovascular events, including myocarditis, has been observed following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, the virus responsible for coronavirus disease 2019 (COVID-19).
• Reports indicate a rise in myocarditis cases among individuals infected with SARS-CoV-2 and those who received COVID-19 mRNA vaccines, necessitating a clear understanding of the associated risks.

Purpose of the Study:

• To quantitatively assess and compare the risk of myocarditis associated with SARS-CoV-2 infection versus COVID-19 vaccination.
• To elucidate the specific risks of myocarditis in unvaccinated versus vaccinated populations in relation to COVID-19.

Main Methods:

• A comprehensive literature search was conducted across PubMed, Google Scholar, and the WHO Global Literature on Coronavirus Disease.
• Relevant randomized controlled trials and cohort studies detailing myocarditis risk from SARS-CoV-2 infection and COVID-19 vaccines were selected.
• A meta-analysis was performed using the inverse variance method with RevMan software to synthesize the compiled data.

Main Results:

• Meta-analysis revealed a significantly higher risk of myocarditis in individuals with COVID-19 infection (Risk Ratio = 5.01, 95% CI = 4.14–6.08) compared to the non-infected population.
• A significant difference in myocarditis risk was observed in those with unspecified vaccination status compared to the non-infected (Risk Ratio = 4.74, 95% CI = 2.40–9.36).
• No statistically significant difference in myocarditis risk was found between vaccinated individuals and the non-infected population (Risk Ratio = 2.55, 95% CI = 0.84–7.74).

Conclusions:

• SARS-CoV-2 infection in unvaccinated individuals is associated with a statistically significant increased risk of developing myocarditis.
• Individuals receiving the COVID-19 vaccine do not exhibit a statistically significant increased risk of myocarditis compared to the uninfected population.
• The findings underscore the importance of vaccination in mitigating the risk of myocarditis associated with COVID-19.