Heidecker, B;
Dagan, N;
Balicer, R;
Eriksson, U;
Rosano, G;
Coats, A;
Tschöpe, C;
Kelle, S;
Poland, GA;
Frustaci, A;
et al.
Heidecker, B; Dagan, N; Balicer, R; Eriksson, U; Rosano, G; Coats, A; Tschöpe, C; Kelle, S; Poland, GA; Frustaci, A; Klingel, K; Martin, P; Hare, JM; Cooper, LT; Pantazis, A; Imazio, M; Prasad, S; Lüscher, TF
(2022)
Myocarditis following COVID-19 vaccine: incidence, presentation, diagnosis, pathophysiology, therapy, and outcomes put into perspective. A clinical consensus document supported by the Heart Failure Association of the European Society of Cardiology (ESC) and the ESC Working Group on Myocardial and Pericardial Diseases.
Eur J Heart Fail, 24 (11).
pp. 2000-2018.
ISSN 1879-0844
https://doi.org/10.1002/ejhf.2669
SGUL Authors: Rosano, Giuseppe Massimo Claudio
|
PDF
Published Version
Available under License Creative Commons Attribution Non-commercial No Derivatives. Download (3MB) | Preview |
|
![]() |
Microsoft Word (.docx) (Appendix S1. Supporting Information.)
Supplemental Material
Download (120kB) |
Abstract
Over 10 million doses of COVID-19 vaccines based on RNA technology, viral vectors, recombinant protein, and inactivated virus have been administered worldwide. Although generally very safe, post-vaccine myocarditis can result from adaptive humoral and cellular, cardiac-specific inflammation within days and weeks of vaccination. Rates of vaccine-associated myocarditis vary by age and sex with the highest rates in males between 12 and 39 years. The clinical course is generally mild with rare cases of left ventricular dysfunction, heart failure and arrhythmias. Mild cases are likely underdiagnosed as cardiac magnetic resonance imaging (CMR) is not commonly performed even in suspected cases and not at all in asymptomatic and mildly symptomatic patients. Hospitalization of symptomatic patients with electrocardiographic changes and increased plasma troponin levels is considered necessary in the acute phase to monitor for arrhythmias and potential decline in left ventricular function. In addition to evaluation for symptoms, electrocardiographic changes and elevated troponin levels, CMR is the best non-invasive diagnostic tool with endomyocardial biopsy being restricted to severe cases with heart failure and/or arrhythmias. The management beyond guideline-directed treatment of heart failure and arrhythmias includes non-specific measures to control pain. Anti-inflammatory drugs such as non-steroidal anti-inflammatory drugs, and corticosteroids have been used in more severe cases, with only anecdotal evidence for their effectiveness. In all age groups studied, the overall risks of SARS-CoV-2 infection-related hospitalization and death are hugely greater than the risks from post-vaccine myocarditis. This consensus statement serves as a practical resource for physicians in their clinical practice, to understand, diagnose, and manage affected patients. Furthermore, it is intended to stimulate research in this area.
Item Type: | Article | ||||||||
---|---|---|---|---|---|---|---|---|---|
Additional Information: | © 2022 The Authors. European Journal of Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. | ||||||||
Keywords: | COVID-19, Inflammation, Myocarditis, Outcomes, Pathology, Vaccination, Adolescent, Adult, Child, Humans, Young Adult, COVID-19, COVID-19 Vaccines, SARS-CoV-2, Humans, Adolescent, Adult, Child, Young Adult, COVID-19, SARS-CoV-2, COVID-19 Vaccines, 1102 Cardiorespiratory Medicine and Haematology, Cardiovascular System & Hematology | ||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) | ||||||||
Journal or Publication Title: | Eur J Heart Fail | ||||||||
ISSN: | 1879-0844 | ||||||||
Language: | eng | ||||||||
Dates: |
|
||||||||
Publisher License: | Creative Commons: Attribution-Noncommercial-No Derivative Works 4.0 | ||||||||
PubMed ID: | 36065751 | ||||||||
Go to PubMed abstract | |||||||||
URI: | https://openaccess.sgul.ac.uk/id/eprint/116143 | ||||||||
Publisher's version: | https://doi.org/10.1002/ejhf.2669 |
Statistics
Actions (login required)
![]() |
Edit Item |