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Long-term effects on cardiac function and symptoms in patients with myocarditis following COVID-19 vaccination: the

Mohammad Nizar Ramadan1,2,3, Filip Soeskov Davidovski4,2,3, Caroline Espersen4,2,3

  • 1Cardiovascular Non-Invasive Imaging Research Laboratory, Copenhagen University Hospital - Herlev & Gentofte Hospital, Hellerup, Denmark mohammad.nizar.ramadan.01@regionh.dk.

Open Heart
|September 29, 2025
PubMed

Insights

Long-term follow-up of COVID-19 vaccine-related myocarditis (V-myocarditis) shows mild cardiac dysfunction and persistent symptoms in some patients, despite normalized biomarkers. Further monitoring is essential.

Area of Science:

  • Cardiology
  • Immunology
  • Public Health

Background:

  • Long-term effects of COVID-19 vaccine-associated myocarditis on cardiac health are not well understood.
  • Assessing cardiac function, inflammatory markers, and symptoms post-vaccination myocarditis is crucial.

Purpose of the Study:

  • To evaluate the long-term cardiac function, inflammatory biomarkers, and symptoms in patients with myocarditis following COVID-19 vaccination.
  • To compare outcomes of vaccine-related myocarditis (V-myocarditis) with non-vaccine-related myocarditis (NV-myocarditis).

Main Methods:

  • Follow-up of 17 patients with V-myocarditis approximately 2 years post-hospitalization.
  • Assessments included echocardiography, biomarkers, ECG, lung ultrasound (LUS), and symptom questionnaires.
  • Comparison with a cohort of NV-myocarditis patients.

Main Results:

  • V-myocarditis patients showed mild left ventricular (LV) dysfunction (GLS 16.0%) and diastolic dysfunction (71%) at follow-up.
  • Biomarkers normalized, but 35% had persistent low-grade inflammation.
  • Fatigue (35%) and chest pain (41%) were common symptoms; V-myocarditis patients had lower GLS than NV-myocarditis controls.

Conclusions:

  • Long-term follow-up reveals mild LV and diastolic dysfunction, preserved RV function, and normalized biomarkers post-COVID-19 vaccine myocarditis.
  • A significant portion of patients experience persistent symptoms, underscoring the need for ongoing monitoring.
  • Outcomes suggest V-myocarditis may lead to subtle, long-term cardiac changes compared to non-vaccine causes.
Abstract

Keywords:
CARDIAC REHABILITATIONEchocardiographyMyocarditis

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