与COVID-19疫苗接种有关的心肌炎:一项韩国全国性的研究
Jae Yeong Cho1,2, Kye Hun Kim1,2, Nuri Lee2,3
1Department of Cardiovascular Medicine, Chonnam National University Medical School, 160 Baekseo-ro, Dong-gu, Gwangju 61469, Korea.
European heart journal
|June 2, 2023
概括
与COVID-19疫苗接种相关的心肌炎 (VRM) 是罕见的,每10万人中发生1.08,男性和mRNA疫苗的发病率更高. 严重的病例,包括急性心脏病死亡,需要监测.
科学领域:
- 心脏病学 心脏病学
- 免疫学 免疫学 免疫学
- 公共卫生 公共卫生
背景情况:
- 接种COVID-19疫苗后的心肌炎 (VRM) 需要全面的发病率和结果分析.
- 了解VRM风险因素和临床轨迹对于公共卫生战略至关重要.
研究的目的:
- 开展一项关于COVID-19疫苗接种相关心肌炎 (VRM) 的发生率和结果的全国性研究.
- 分析VRM的人口和疫苗特异性风险因素.
- 评估确认VRM病例的临床过程和严重程度.
主要方法:
- 对44276704名接受至少1剂COVID-19疫苗的个人进行了分析.
- 韩国疾病控制和预防局专家评审委员会确认VRM病例.
- 发病率和结果数据按性别,年龄和疫苗类型分层.
主要成果:
- 每10万人的VRM发病率为1.08例,男性 (1.35/100,000) 和使用mRNA疫苗 (1.46/100,000) 的人明显高.
- 在12-17岁的男性中观察到的最高发病率 (5.29/100,000);在70岁以上的女性中观察到的最低发病率 (0.16/100,000).
- 严重的VRM发生在19.8%的病例中,包括7.5%的发性心肌炎和4.4%的死亡,其中4.4%的心脏突然死亡,特别是在接受mRNA疫苗的年轻男性中.
结论:
- COVID-19 VRM 很少见,但在一小部分病例中可能会出现严重的结果.
- 突然心脏病死亡是VRM的关键,可能致命的并发症,需要密切监视.
- 公共卫生工作应专注于监测和管理VRM,特别是在高风险人口群体和mRNA接种疫苗后.
相关概念视频
Myocarditis III: Medical Management
9
Myocarditis: Comprehensive Medical ManagementMyocarditis, the heart muscle inflammation, requires a comprehensive medical management strategy that addresses the underlying cause, provides supportive care, manages symptoms, and reduces cardiac workload.Infections and Autoimmune CausesAdminister appropriate antimicrobial therapy when an infectious agent causes myocarditis. For instance, penicillin treats infections caused by Group A Streptococcus. In cases where autoimmune processes are...
9
Myocarditis I: Introduction
12
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
12
Myocarditis II: Clinical Features and Diagnostic Tests
12
Myocarditis is an inflammation of the heart muscle. The symptoms vary widely, encompassing asymptomatic presentations to severe, acute manifestations.Clinical PresentationAsymptomatic cases: In some instances, myocarditis may be asymptomatic, with the infection resolving without intervention. These cases often go undetected unless discovered incidentally through diagnostic imaging or tests conducted for other reasons.General Early Symptoms: Early symptoms of myocarditis are non-specific and can...
12
Acute Coronary Syndrome III: Diagnostic Studies
12
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
12
Rheumatic Heart Disease II: Clinical Manifestations and Diagnostic Studies
38
The key clinical manifestations of Rheumatic heart disease (RHD) include several distinct cardiac symptoms.Carditis, a hallmark of acute rheumatic fever, involves inflammation of the heart's endocardium, myocardium, and pericardium. Chronic RHD often results from recurrent episodes of carditis. Its symptoms include the following:Murmurs are caused by valvular damage, especially to the mitral and aortic valves. Mitral stenosis or regurgitation is common, with characteristic heart murmurs...
38
Coronary Artery Disease IV: Preventive Measures
25
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
25


