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

Ranel Thaker1, James Faraci2, Sierra Derti1

  • 1Internal Medicine, Lake Erie College of Osteopathic Medicine, Elmira, USA.

Cureus
|December 4, 2023
PubMed

Insights

COVID-19 infection significantly increases myocarditis risk in unvaccinated individuals. However, COVID-19 vaccination does not show a statistically significant increased risk for myocarditis compared to the uninfected population. Further research is warranted.

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.

Keywords:
covid-19covid-19 and myocarditiscovid-19 vaccinesars-cov-2vaccine-associated myocarditis

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