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COVID-19 and Myocarditis: Trends, Clinical Characteristics, and Future Directions
Mohammad Abumayyaleh1, Tobias Schupp1, Michael Behnes1
1Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, Medical Faculty Mannheim, University Medical Center Mannheim, Heidelberg University, 68167 Mannheim, Germany.
Journal of Clinical Medicine
|July 12, 2025
Summary
COVID-19 can cause myocarditis, a heart inflammation. While rare after vaccination, COVID-19-associated myocarditis requires careful management and follow-up for cardiovascular complications.
Area of Science:
- Cardiology
- Infectious Diseases
- Immunology
Background:
- COVID-19 (caused by SARS-CoV-2) is linked to cardiovascular issues, including myocarditis.
- Myocarditis can occur both from the infection and following SARS-CoV-2 vaccination.
Purpose of the Study:
- To systematically review clinical features, pathophysiology, diagnosis, and management of COVID-19-associated myocarditis.
- To compare COVID-19-related myocarditis with vaccine-associated myocarditis.
Main Methods:
- Systematic literature search of PubMed up to early 2024.
- Inclusion of studies on "COVID-19", "SARS-CoV-2", "vaccination", and "myocarditis" or "cardiac injury".
Main Results:
- COVID-19-associated myocarditis prevalence ranges from 2.3% to 5.0%; myocardial injury is more common.
- Mechanisms include direct viral damage, immune response, and molecular mimicry.
- Vaccine-associated myocarditis is rare, primarily in young males, with a good prognosis.
Conclusions:
- COVID-19 increases risks for heart failure and other cardiac complications.
- Vaccine benefits outweigh risks despite rare myocarditis.
- Further research is needed for optimal management strategies and evidence-based treatment algorithms.
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