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Assessment of the Association between Myocarditis (New-onset Heart Failure) and COVID-19 and COVID-19 Vaccination
Kiana Karimi1,2, Nakisa Khansari1,3, Amirhossein Yazdi3
1Clinical Research Development Unit of Farshchian Heart Hospital, Hamadan University of Medical Sciences, Hamadan, Iran.
Introduction:
Myocarditis is a rare but significant cardiovascular complication that may occur after receiving COVID-19 vaccines, particularly in younger individuals. The majority of cases have been reported after receiving mRNA-based vaccines, while inactivated and viral vector-based vaccines have been associated with fewer occurrences. Despite this, myocarditis is much more common and results in a poorer prognosis following COVID-19 infection. However, the relationship between myocarditis post-vaccination and its potential mechanisms remains unclear due to limited information.
Methods:
This study investigated patients with myocarditis (new-onset heart failure) who had received the COVID-19 vaccine and those who had been infected with COVID-19 between March 2021 and March 2023 in Farshchian Cardiovascular Hospital in Hamedan. The data was analyzed using Stata version 14 software and Python.
Results:
Among 146 myocarditis patients, unvaccinated individuals had higher rates of hypertension, diabetes, obstructive pulmonary disease, and substance abuse, and exhibited more severe cardiac issues like mitral regurgitation and ventricular dysfunction. Vaccinated patients had better lab results and fewer severe symptoms. A model identified advanced age and cardiovascular dysfunction as key mortality risks, suggesting vaccination may mitigate severe cardiac complications and improve outcomes.
Conclusion:
The findings of this study show that although there is a risk of myocarditis as a side effect following the COVID-19 vaccination, its severity is far less than the occurrence following the COVID-19 infection, with fewer complications and a better prognosis. However, more studies are still necessary to complete the existing findings and clarify their unknown aspects.
Insights
COVID-19 vaccination is associated with a lower risk and severity of myocarditis compared to COVID-19 infection. While vaccine-related myocarditis occurs, it presents with fewer complications and a better prognosis than infection-induced myocarditis.
Area of Science:
- Cardiology
- Infectious Diseases
- Vaccinology
Background:
- Myocarditis, a rare cardiovascular complication, can occur post-COVID-19 vaccination, predominantly after mRNA vaccines.
- Despite vaccine risks, myocarditis is significantly more common and severe following COVID-19 infection.
- Limited information exists on the mechanisms and full scope of post-vaccination myocarditis.
Purpose of the Study:
- To compare the clinical characteristics and outcomes of myocarditis in COVID-19 vaccinated individuals versus those infected with COVID-19.
- To identify risk factors for mortality in myocarditis patients post-vaccination and infection.
Main Methods:
- Retrospective analysis of 146 myocarditis patients diagnosed between March 2021 and March 2023.
- Comparison of clinical data, comorbidities, and outcomes between vaccinated and unvaccinated myocarditis patients.
- Statistical analysis using Stata 14 and Python.
Main Results:
- Unvaccinated myocarditis patients exhibited higher rates of comorbidities (hypertension, diabetes, COPD, substance abuse) and severe cardiac issues (mitral regurgitation, ventricular dysfunction).
- Vaccinated patients demonstrated improved laboratory results and experienced fewer severe symptoms.
- Advanced age and cardiovascular dysfunction were identified as key mortality risks, with vaccination potentially mitigating severe complications.
Conclusions:
- COVID-19 vaccination carries a risk of myocarditis, but it is less severe and has a better prognosis than myocarditis following COVID-19 infection.
- Vaccination may reduce the severity of cardiac complications associated with myocarditis.
- Further research is needed to fully understand the unknown aspects and complete the findings regarding vaccine-associated myocarditis.
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