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Tri Saputra PB, Kurniawan RB, Trilistyoati D, Al Farabi MJ, Susilo H, Alsagaff MY, Oktaviono YH, Sutanto H, Gusnanto A, Dyah Kencono Wungu C. Myocarditis and coronavirus disease 2019 vaccination: A systematic review and meta-summary of cases. BIOMOLECULES & BIOMEDICINE 2023; 23:546-567. [PMID: 36803547 PMCID: PMC10351100 DOI: 10.17305/bb.2022.8779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/16/2023] [Accepted: 02/16/2023] [Indexed: 02/23/2023]
Abstract
Vaccination is significant to control, mitigate, and recover from the destructive effects of coronavirus disease 2019 (COVID-19). The incidence of myocarditis following COVID-19 vaccination has been increasing and growing public concern; however, little is known about it. This study aimed to systematically review myocarditis following COVID-19 vaccination. We included studies containing individual patient data of myocarditis following COVID-19 vaccination published between January 1, 2020 and September 7, 2022 and excluded review articles. Joanna Briggs Institute critical appraisals were used for risk of bias assessment. Descriptive and analytic statistics were performed. A total of 121 reports and 43 case series from five databases were included. We identified 396 published cases of myocarditis and observed that the majority of cases was male patients, happened following the second dose of mRNA vaccine administration, and experienced chest pain as a symptom. Previous COVID-19 infection was significantly associated (p < 0.01; OR, 5.74; 95% CI, 2.42-13.64) with the risk of myocarditis following the administration of the first dose, indicating that its primary mechanism is immune-mediated. Moreover, 63 histopathology examinations were dominated by non-infective subtypes. Electrocardiography and cardiac marker combination is a sensitive screening modality. However, cardiac magnetic resonance is a significant noninvasive examination to confirm myocarditis. Endomyocardial biopsy may be considered in confusing and severe cases. Myocarditis following COVID-19 vaccination is relatively benign, with a median length of hospitalization of 5 days, intensive care unit admission of <12%, and mortality of <2%. The majority was treated with nonsteroidal anti-inflammatory drugs, colchicine, and steroids. Surprisingly, deceased cases had characteristics of being female, older age, non-chest pain symptoms, first-dose vaccination, left ventricular ejection fraction of <30%, fulminant myocarditis, and eosinophil infiltrate histopathology.
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Affiliation(s)
- Pandit Bagus Tri Saputra
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga–Dr Soetomo General Academic Hospital, Surabaya, Indonesia
| | | | | | - Makhyan Jibril Al Farabi
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga–Dr Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Hendri Susilo
- Department of Cardiology and Vascular Medicine, Universitas Airlangga Hospital, Surabaya, Indonesia
| | - Mochamad Yusuf Alsagaff
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga–Dr Soetomo General Academic Hospital, Surabaya, Indonesia
- Department of Cardiology and Vascular Medicine, Universitas Airlangga Hospital, Surabaya, Indonesia
| | - Yudi Her Oktaviono
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Airlangga–Dr Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Henry Sutanto
- Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands
| | | | - Citrawati Dyah Kencono Wungu
- Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
- Institute of Tropical Disease, Universitas Airlangga, Surabaya, Indonesia
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Felip E, Pradenas E, Romeo M, Marfil S, Trinité B, Urrea V, Hernández A, Ballana E, Cucurull M, Mateu L, Massanella M, Clotet B, Morán T, Blanco J. Impact of chemotherapy and/or immunotherapy on neutralizing antibody response to SARS-CoV-2 mRNA-1237 vaccine in patients with solid tumors. Mol Oncol 2023; 17:686-694. [PMID: 36495129 PMCID: PMC9877816 DOI: 10.1002/1878-0261.13359] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/02/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
Patients with solid tumors have been a risk group since the beginning of the SARS-CoV-2 pandemic due to more significant complications, hospitalizations or deaths. The immunosuppressive state of cancer treatments or the tumor itself could influence the development of post-vaccination antibodies. This study prospectively analyzed 89 patients under chemotherapy and/or immunotherapy, who received two doses of the mRNA-1237 vaccine, and were compared with a group of 26 non-cancer individuals. Information on adverse events and neutralizing antibodies against the ancestral strain of SARS-CoV-2 (WH1) have been analyzed. Local reactions accounted for 65%, while systemic reactions accounted for 46% of oncologic individuals/cancer patients. Regarding the response to vaccination, 6.7% of cancer patients developed low neutralizing antibody levels. Lower levels of neutralizing antibodies between cancer and non-cancer groups were significant in individuals without previous SARS-CoV-2 infection, but not in previously infected individuals. We also observed that patients receiving chemotherapy or chemoimmunotherapy have significantly lower levels of neutralizing antibodies than non-cancer individuals. In conclusion, our study confirms the importance of prioritizing cancer patients receiving anticancer treatment in SARS-CoV-2 vaccination programs.
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Affiliation(s)
- Eudald Felip
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | | | - Margarita Romeo
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | | | | | | | - Ainhoa Hernández
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | - Ester Ballana
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- Germans Trias i Pujol Research Institute (IGTP)BadalonaSpain
- CIBER Infectious Diseases (CIBERINFEC), Carlos III Institute of Health (ISCIII)MadridSpain
| | - Marc Cucurull
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | - Lourdes Mateu
- Infectious Diseases DepartmentHospital Universitari Germans Trias i PujolBadalonaSpain
- Fundació Lluita contra les InfeccionsHospital Universitari Germans Trias i PujolBadalonaSpain
- Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Carlos III Institute of Health (ISCIII)MadridSpain
- University of Vic–Central University of Catalonia (UVic‐UCC)Spain
| | - Marta Massanella
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- CIBER Infectious Diseases (CIBERINFEC), Carlos III Institute of Health (ISCIII)MadridSpain
- University of Vic–Central University of Catalonia (UVic‐UCC)Spain
| | - Bonaventura Clotet
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- CIBER Infectious Diseases (CIBERINFEC), Carlos III Institute of Health (ISCIII)MadridSpain
- University of Vic–Central University of Catalonia (UVic‐UCC)Spain
| | - Teresa Morán
- Medical Oncology Department, Catalan Institute of Oncology – BadalonaBadalona Applied Research Group in Oncology (B‐ARGO)Spain
| | - Julià Blanco
- IrsiCaixa AIDS Research InstituteBadalonaSpain
- Germans Trias i Pujol Research Institute (IGTP)BadalonaSpain
- CIBER Infectious Diseases (CIBERINFEC), Carlos III Institute of Health (ISCIII)MadridSpain
- University of Vic–Central University of Catalonia (UVic‐UCC)Spain
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Sheriff MM, Basalib SG, Mereani MJ, Bakhsh LM, Alzamzami BA, Garout RM. Intricacies Affiliated With Post-COVID Vaccine Complications in Makkah Province, Saudi Arabia. Cureus 2022; 14:e32749. [PMID: 36578849 PMCID: PMC9789788 DOI: 10.7759/cureus.32749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction COVID-19 vaccine side effects have a fundamental role in public confidence in the vaccine and its uptake process. Thus far, evidence on vaccine safety has been exclusively obtained from manufacturer-sponsored studies; therefore, this study is designed to assess post-COVID-19 vaccine complications in Makkah province, Saudi Arabia. Method A cross-sectional study included 840 subjects conducted from August to November 2022 to collect data about COVID-19 vaccine side effects. A validated questionnaire was used with 21 multiple-choice items covering demographic data, COVID-19 vaccination type, side effects, and medication used to relieve side effects. The online Raosoft sample size calculator (Raosoft Inc., Seattle, Washington) was utilized for sample size calculation. The Statistical Package for the Social Sciences version 22.0 (IBM Inc., Armonk, New York) was utilized to carry out descriptive statistics. The Shapiro-Wilk test was used to evaluate normal data distribution. Significance of categorized data made by the Pearson's Chi-Squared test and of the vaccination side effects experienced in general wellbeing on a scale of 1-10 by the Kruskal-Wallis test. Result The survey found that most participants in the 18-26 age group were from Jeddah, women, and Saudis. Only 7.1% of participants had comorbidities alone, and 63.1% of participants had previously had COVID-19. The vaccine types used in this study were primarily Pfizer (83.3%), AstraZeneca (9.5%), Moderna (3.6%), and combination vaccines (3.6%). The majority of the participants received vaccination up to the third dose. No side effects were reported by 9.5% of participants, while mild and severe side effects were reported by 90.5% and 23.8% of participants, respectively. Mild side effects included injection site pain, redness, tenderness, or itching (34.5%), fatigue (22.6%), low-grade fever, chills, diarrhea, headache (17.9%), and myalgia (14.3%). Conclusion The majority of the side effects of COVID-19 vaccination were minor reactions (90.5%), but 23.8% were found to be serious side effects, most of which lasted one to three days. More independent studies are needed to investigate gender differences, COVID-19 vaccine efficacy, and the prevalence of side effects in other populations conducted by academic institutions. Additional independent research on vaccine safety is urgently needed to increase public confidence in vaccines and to better understand risk factors for vaccine side effects.
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Affiliation(s)
- Muazzam M Sheriff
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Samaher G Basalib
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Maya J Mereani
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Layali M Bakhsh
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Bayan A Alzamzami
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | - Raha M Garout
- Medicine, Ibn Sina National College for Medical Studies, Jeddah, SAU
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Muacevic A, Adler JR, Akram A, Sanusi M, Khan AA, Momin ES, Pervaiz MA, Elshaikh AO. COVID-19 Vaccination-Associated Myocarditis: A Literature Review. Cureus 2022; 14:e32022. [PMID: 36589180 PMCID: PMC9797869 DOI: 10.7759/cureus.32022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/29/2022] [Indexed: 11/30/2022] Open
Abstract
Myocarditis is defined as a non-ischemic inflammation of the middle layer of the heart. It ensues changes that can lead to acute heart failure, dilated cardiomyopathy, and sudden death. Myocarditis is caused by several infectious and non-infectious agents. Vaccines are also known to cause myocarditis. The use of the coronavirus disease (COVID-19) vaccination was started to combat the severity of the COVID-19 infection and reduce the mortality and morbidity associated with it. The vaccination, however, caused side effects like myocarditis, among others. In order to investigate the association between the COVID-19 vaccination and myocarditis in adults and adolescents, we conducted a literature review by searching three databases: Google Scholar, PubMed, and ScienceDirect. From the published literature, we found that, though it is rare, the various vaccinations available can cause symptoms of myocarditis as a side effect more commonly in patients who have received both doses of a particular vaccine and that there are significant changes in cardiac magnetic resonance imaging (CMRI) and other biochemical markers, with young males being more commonly affected. Further prospective trial-based studies are required to establish a concrete relationship between myocarditis and the COVID-19 vaccine.
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de Brito BB, Marques HS, Silva FAFD, Cordeiro Santos ML, Araújo GRL, Valente LDA, Freire de Melo F. Influence of the COVID-19 pandemic in the gastrointestinal oncology setting: An overview. World J Gastrointest Pathophysiol 2022; 13:157-169. [PMID: 36187602 PMCID: PMC9516457 DOI: 10.4291/wjgp.v13.i5.157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 05/27/2022] [Accepted: 08/18/2022] [Indexed: 02/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been impacting healthcare in various ways worldwide and cancer patients are greatly affected by the coronavirus disease 2019 (COVID-19) pandemic. The reorganization of the health facilities in order to supply the high demand resulting from the aforementioned infection as well as the social isolation measures led to impairments for the diagnosis and follow-up of patients with gastrointestinal cancers, which has had an impact on the prognosis of the oncologic patients. In that context, health authorities and organizations have elaborated new guidelines with specific recommendations for the management of individuals with gastrointestinal neoplasms during the pandemic. Of note, oncologic populations seem to be more susceptible to unfavorable outcomes when exposed to SARS-CoV-2 infection and some interactions involving virus, tumor, host immune system and anticancer therapies are probably related to the poorer prognosis observed in those COVID-19 patients. Moreover, vaccination stands out as the main prevention method against severe SARS-CoV-2 infection and some particularities have been observed regarding the seroconversion of vaccinated oncologic patients including those with gastrointestinal malignancies. In this minireview, we gather updated information regarding the influence of the pandemic in the diagnosis of gastrointestinal neoplasms, new recommendations for the management of gastrointestinal cancer patients, the occurrence of SARS-CoV-2 infection in those individuals and the scenario of the vaccination against the virus in that population.
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Affiliation(s)
- Breno Bittencourt de Brito
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Hanna Santos Marques
- Campus Vitória da Conquista, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista 45055-380, Bahia, Brazil
| | | | - Maria Luísa Cordeiro Santos
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Glauber Rocha Lima Araújo
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Lara de Araujo Valente
- Campus Vitória da Conquista, Universidade Estadual do Sudoeste da Bahia, Vitória da Conquista 45055-380, Bahia, Brazil
| | - Fabrício Freire de Melo
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Brazil
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