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COVID-19 Vaccination-Related Pericarditis: A Korean Nationwide Study
Nuri Lee1, Kye Hun Kim2, Jae-Hyeong Park3
1Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea; Department of Cardiovascular Medicine, Chonnam National University Hwasun Hospital, Hwasun, Jeollanam-do, Korea.
Mayo Clinic Proceedings
|August 2, 2024
Summary
COVID-19 vaccine-related pericarditis (VRP) is rare, primarily affecting males under 40 who received mRNA vaccines. While generally mild with no deaths, significant pericardial effusion requires monitoring.
Area of Science:
- Cardiology
- Vaccinology
- Public Health
Background:
- Pericarditis is inflammation of the pericardium, the sac surrounding the heart.
- COVID-19 vaccines have been associated with rare adverse events, including myocarditis and pericarditis.
- Understanding vaccine-related pericarditis (VRP) without myocarditis is crucial for vaccine safety monitoring.
Purpose of the Study:
- To determine the incidence of COVID-19 vaccine-related pericarditis (VRP) without myocarditis in Korea.
- To characterize the clinical features and outcomes of VRP.
- To identify demographic and vaccine-specific risk factors for VRP.
Main Methods:
- Retrospective nationwide analysis of COVID-19 vaccinated individuals in Korea (February-December 2021).
- Inclusion of all vaccine platforms: BNT162b2, mRNA-1273, ChAdOx1, Ad26.COV2.S.
- Confirmed VRP cases adjudicated by an Expert Committee; analysis of incidence, characteristics, and outcomes.
Main Results:
- 179 cases of VRP identified among 44,322,068 vaccinated individuals (1.73 per million doses).
- Higher VRP incidence in males (2.01/million), mRNA vaccines (2.09/million), and individuals <40 years (3.52/million).
- Highest incidence in males aged 12-17 years (7.38/million); 5.6% developed significant pericardial effusion, no mortality.
Conclusions:
- COVID-19 VRP is a rare adverse event, predominantly linked to mRNA vaccines in younger males.
- The clinical course of VRP is generally favorable with no reported deaths.
- Close monitoring for hemodynamically significant pericardial effusion is recommended.
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