1
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Klement RJ, Walach H. Commentary: raised c-troponin levels as a sign of myocardial injury after COVID-19 vaccination in healthy individuals are worrying. Egypt Heart J 2024; 76:16. [PMID: 38300486 PMCID: PMC10834889 DOI: 10.1186/s43044-024-00441-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/21/2024] [Indexed: 02/02/2024] Open
Abstract
BACKGROUND Recently, Buergin et al. (Eur J Heart Fail 25(10):1871-1881, 2023 doi:10.1002/ejhf.2978) thoroughly measured a frequency of 2.8% elevated high-sensitivity cardiac troponin T levels, a sign of myocardial damage, after mRNA-1273 (Moderna) booster vaccinations. In their discussion, they claim that before vaccinations were available, the incidence and extent of myocardial damage associated with COVID-19 infection would have been much higher. We here scrutinize this claim based on empirical data. MAIN BODY Burgin et al. have only cited papers in support of their claim which considered hospitalized COVID-19 patients. After extracting COVID-19 infection data from Germany and Switzerland and the expected frequency of elevated troponin levels after COVID-19 infection in both hospitalized and non-hospitalized individuals, we find that the extent of myocardial damage after vaccinating a considerable proportion of the general population is expected to be much higher than after natural infections. CONCLUSIONS The claim that the extent of myocardial injury after COVID-19 infection would be higher than after vaccination is not supported by empirical evidence and therefore wrong. We conclude that cross-national systematic observational studies should be conducted that allow a more precise estimation of the risk-benefit ratio of COVID-19 mRNA vaccinations.
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Affiliation(s)
- Rainer Johannes Klement
- Department of Radiation Oncology, Leopoldina Hospital, Robert-Koch-Strasse 10, 97422, Schweinfurt, Germany.
| | - Harald Walach
- Next Society Institute, Kazimieras Simonavicius University, Vilnius, Lithuania
- Change Health Science Institute, Basel, Switzerland
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2
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Jaiswal V, Mukherjee D, Peng Ang S, Kainth T, Naz S, Babu Shrestha A, Agrawal V, Mitra S, Ee Chia J, Jilma B, Mamas MA, Gebhard C, Postula M, Siller-Matula JM. COVID-19 vaccine-associated myocarditis: Analysis of the suspected cases reported to the EudraVigilance and a systematic review of the published literature. IJC HEART & VASCULATURE 2023; 49:101280. [PMID: 38143781 PMCID: PMC10746454 DOI: 10.1016/j.ijcha.2023.101280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 08/31/2023] [Accepted: 09/21/2023] [Indexed: 12/26/2023]
Abstract
Background Myocarditis secondary to Coronavirus Disease 2019 (COVID-19) vaccination has been reported in the literature. Objective This study aimed to characterize the reported cases of myocarditis after COVID-19 vaccination based on age, gender, doses, and vaccine type from published literature and the EudraVigilance database. Methods We performed an analysis in the EudraVigilance database (until December 18, 2021) and a systematic review of published literature for reported cases of suspected myocarditis and pericarditis (until 30th June 2022) after the COVID-19 vaccination. Results EudraVigilance database analysis revealed 16,514 reported cases of myocarditis or pericarditis due to the vaccination with COVID-19 vaccines. The cases of myo- or pericarditis were reported predominantly in the age group of 18-64 (n = 12,214), and in males with a male-to-female (M: F) ratio of 1.7:1. The mortality among myocarditis patients was low, with 128 deaths (2 cases per 10.000.000 administered doses) being reported. For the systematic review, 72 studies with 1026 cases of myocarditis due to the vaccination with COVID-19 vaccines were included. The analysis of published cases has revealed that the male gender was primarily affected with myocarditis post-COVID-vaccination. The median (IQR) age of the myocarditis cases was 24.6 [19.5-34.6] years, according to the systematic review of the literature. Myocarditis cases were most frequently published after the vaccination with m-RNA vaccines and after the second vaccination dose. The overall mortality of published cases was low (n = 5). Conclusion Myocarditis is a rare serious adverse event associated with a COVID-19 vaccination. With early recognition and management, the prognosis of COVID-19 vaccine-induced myocarditis is favorable.
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Affiliation(s)
| | | | - Song Peng Ang
- Department of Internal Medicine, Rutgers Health Community Medical Center, Toms River, NJ, USA
| | - Tejasvi Kainth
- Department of Psychiatry, Bronxcare Health System, NY, USA
| | - Sidra Naz
- Department of Internal Medicine, Harvard Medical School/BIDMC, Boston, USA
| | | | | | - Saloni Mitra
- OO Bogomolets National Medical University, Kyiv, Ukraine
| | - Jia Ee Chia
- Department of Internal Medicine, Texas Tech University Health Sciences, El Paso, TX, USA
| | - Bernd Jilma
- Department of Clinical Pharmacology, Medical University of Vienna, Austria
| | - Mamas A. Mamas
- Keele Cardiovascular Research Group, Keele University, Keele, UK
| | - Catherine Gebhard
- Department of Cardiology, Inselspital, Bern University Hospital, Switzerland
| | - Marek Postula
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, Center for Preclinical Research and Technology CEPT, Warsaw, Poland
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3
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Elsaid M, Nune A, Hesham D, Fouad FM, Hassan H, Hamouda H, Sherif H, Abdelwahab MM, Hegazi N, El-Rahman YA. Multisystem Inflammatory Syndrome (MIS) following SARS-CoV-2 vaccinations; a systematic review. Trop Dis Travel Med Vaccines 2023; 9:19. [PMID: 37925466 PMCID: PMC10625711 DOI: 10.1186/s40794-023-00204-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/29/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Although SARS-CoV-2 vaccines are generally safe, there are growing concerns about their link to a potentially life-threatening multi-system inflammatory syndrome following vaccination (MIS-V). We conducted this systematic review to elucidate the prevalence of MIS, severity, treatment, and outcomes following SARS-CoV-2 vaccination. METHODS We searched PubMed, Scopus, ScienceDirect, Google Scholar, Virtual Health Library (VHL), Cochrane Library, and Web of Science databases for articles and case reports about MIS-V. We performed a qualitative analysis of individual cases from the included studies. RESULTS Of the 1366 studies identified by database search, we retrieved twenty-six case reports and two cohort studies. We analyzed the data of 37 individual cases extracted from 27 articles. The average age of the cases included in this review was 18 (1-67) years, with the most being male (M: F 3.1:1). Of the 37 included cases, the cardiovascular system was the most affected system by MIS (36, 97.3%), followed by the gastrointestinal tract (32, 86.5%). CONCLUSION MIS after SARS-CoV-2 vaccinations can be fatal, but the incidence is low. Prompt recognition of MIS and ruling out the mimickers are critical in the patient's early recovery.
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Affiliation(s)
- Mohamed Elsaid
- Faculty of Medicine, 6Th of October, Misr University for Science and Technology, Giza, Egypt.
- Medical Research Platform, Giza, Egypt.
| | - Arvind Nune
- Department of Rheumatology and General Medicine, Southport and Ormskirk Hospital NHS Trust, Southport, UK.
| | - Deyaa Hesham
- Medical Research Platform, Giza, Egypt
- Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Fatma Mohamed Fouad
- Medical Research Platform, Giza, Egypt
- Faculty of Science, Cairo University, Giza, Egypt
- Biology Department, College of Science, Sultan Qaboos University, Muscat, Oman
| | - Hamsa Hassan
- Medical Research Platform, Giza, Egypt
- Faculty of Pharmacy, Mansoura University, Mansoura, Egypt
| | - Heba Hamouda
- Medical Research Platform, Giza, Egypt
- Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Huda Sherif
- Medical Research Platform, Giza, Egypt
- Faculty of Medicine, Menoufia University, Menoufia, Egypt
| | - Maya Magdy Abdelwahab
- Medical Research Platform, Giza, Egypt
- Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Nourelhoda Hegazi
- Medical Research Platform, Giza, Egypt
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Yasmena Abd El-Rahman
- Medical Research Platform, Giza, Egypt
- Faculty of Medicine, Portsaid University, Portsaid, Egypt
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4
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Ho JSY, Sia CH, Ngiam JN, Loh PH, Chew NWS, Kong WKF, Poh KK. A review of COVID-19 vaccination and the reported cardiac manifestations. Singapore Med J 2023; 64:543-549. [PMID: 34808708 PMCID: PMC10564100 DOI: 10.11622/smedj.2021210] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/18/2021] [Indexed: 12/21/2022]
Abstract
In Singapore, 9.03 million doses of the mRNA COVID-19 vaccines by Pfizer-BioNTech and Moderna have been administered, and 4.46 million people are fully vaccinated. An additional 87,000 people have been vaccinated with vaccines in World Health Organization's Emergency Use Listing. The aim of this review is to explore the reported cardiac adverse events associated with different types of COVID-19 vaccines. A total of 42 studies that reported cardiac side effects after COVID-19 vaccination were included in this study. Reported COVID-19 vaccine-associated cardiac adverse events were mainly myocarditis and pericarditis, most commonly seen in adolescent and young adult male individuals after mRNA vaccination. Reports of other events such as acute myocardial infarction, arrhythmia and stress cardiomyopathy were rare. Outcomes of post-vaccine myocarditis and pericarditis were good. Given the good vaccine efficacy and the high number of cases of infection, hospitalisation and death that could potentially be prevented, COVID-19 vaccine remains of overall benefit, based on the current available data.
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Affiliation(s)
- Jamie Sin Ying Ho
- Academic Foundation Programme, Royal Free London NHS Trust, London, UK
| | - Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jinghao Nicholas Ngiam
- Division of Infectious Diseases, Department of Medicine, National University Health System, Singapore
| | - Poay Huan Loh
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | | | - William Kok-Fai Kong
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kian-Keong Poh
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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5
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Md Hussin NS, Karuppannan M, Gopalan Y, Tan KM, Gnanasan S. Exploration of non-pharmacological interventions in the management of behavioural and psychological symptoms of dementia. Singapore Med J 2023; 64:497-502. [PMID: 34600449 PMCID: PMC10476919 DOI: 10.11622/smedj.2021125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 01/07/2021] [Indexed: 11/18/2022]
Abstract
Introduction Behavioural and psychological symptoms of dementia (BPSD) are considered integral parts of dementia. While pharmacotherapy is reserved for severe symptoms of BPSD, the associated adverse effects can be detrimental. Therefore, non-pharmacological intervention is recommended as the first line of treatment in the management of BPSD. This study aimed to explore the non-pharmacological approaches for the management of BPSD and the strategies and barriers to implementing them in secondary care facilities in Malaysia. Methods A qualitative study design was employed. Data were collected through observations and semi-structured interviews of 12 caregivers and 11 people with dementia (PWD) at seven secondary care facilities. Observations were written in the field notes, and interviews were audio-recorded and transcribed. All data were subjected to thematic analysis. Results Some personalised non-pharmacological interventions, such as physical exercise, music therapy, reminiscence therapy and pet therapy, were conducted in several nursing care centres. Collaborative care from the care providers and family members was found to be an important facilitating factor. The lack of family support led to care providers carrying additional workload beyond their job scope. Other barriers to non-pharmacological interventions were cultural and language differences between the care providers and PWD, inadequate staff numbers and training, and time constraints. Conclusion Although non-pharmacological approaches have been used to some extent in Malaysia, continuous education and training of healthcare providers and the family members of PWD is needed to overcome the challenges to their successful implementation.
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Affiliation(s)
- Nur Sabiha Md Hussin
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Selangor, Malaysia
| | - Mahmathi Karuppannan
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Selangor, Malaysia
| | - Yogheswaran Gopalan
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Selangor, Malaysia
| | - Kit Mun Tan
- Division of Geriatric Medicine, Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shubashini Gnanasan
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Selangor, Malaysia
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Shaheen N, Ramadan A, Shaheen A, Elmasry M, Swed S, Hafez W, Wael M. Myocarditis Following COVID-19 Vaccination: A Systematic Review. Cureus 2023; 15:e37999. [PMID: 37223162 PMCID: PMC10203748 DOI: 10.7759/cureus.37999] [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: 04/22/2023] [Indexed: 05/25/2023] Open
Abstract
COVID-19 vaccination has significantly reduced both the morbidity and mortality rates associated with SARS-CoV-2 infection. Vaccines, especially mRNA vaccines, have been proposed in several studies to complicate viral myocarditis. Thus, our systematic and meta-analysis review aims to further investigate the possibility of an association between COVID-19 vaccines and myocarditis. We systematically searched PubMed, Web of Science, Scopus, Ovid, and Google Scholar and did a gray search of other databases using the following keywords and terms: "Myocarditis ("Myocarditis" Mesh) OR "Chagas Cardiomyopathy" Mesh) AND "COVID-19 Vaccines" Mesh. The studies were limited to only English articles that reported myocardial inflammation or myocarditis associated with COVID-19 vaccines. Pooled risk ratio with its 95% confidence interval was analyzed by RevMan software (5.4) to perform the meta-analysis. Our study included 671 patients from 44 studies with a mean age of 14-40 years. Nevertheless, myocarditis was noted in a mean of (3.227) days, and 4.19 per million vaccination recipients experienced myocarditis. Most cases were clinically presented with manifestations of cough, chest pain, and fever. Laboratory tests revealed increased C-reactive protein, and troponin with all other cardiac markers in most patients. Cardiac magnetic resonance imaging (MRI) revealed late gadolinium enhancement with myocardial edema and cardiomegaly. Also, electrocardiograms revealed ST-segment elevation in most patients. Furthermore, the incidence of myocarditis was statistically significantly lower in the COVID-19 vaccine group as compared with the control group (RR = 0.15, 95% CI = 0.10-0.23, p-value < 0.00001). No significant association was found between COVID-19 vaccines and the incidence of myocarditis. The study's findings highlight the importance of implementing evidence-based COVID-19 prevention strategies, such as vaccination, to reduce the public health impact of COVID-19 and its associated complications.
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Affiliation(s)
- Nour Shaheen
- Faculty of Medicine, Alexandria University, Alexandria, EGY
| | | | - Ahmed Shaheen
- Faculty of Medicine, Alexandria University, Alexandria, EGY
| | | | - Sarya Swed
- Medicine, Aleppo University, Aleppo, SYR
| | - Wael Hafez
- Internal Medicine, NMC (New Medical Centre) Royal Hospital, Abu Dhabi, ARE
- Internal Medicine, The National Research Centre, Cairo, EGY
| | - Muhannad Wael
- Faculty of Medicine, An-Najah National University, Jerusalem, PSE
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7
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Goyal M, Ray I, Mascarenhas D, Kunal S, Sachdeva RA, Ish P. Myocarditis post-SARS-CoV-2 vaccination: a systematic review. QJM 2023; 116:7-25. [PMID: 35238384 PMCID: PMC8903459 DOI: 10.1093/qjmed/hcac064] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 02/24/2022] [Accepted: 02/26/2022] [Indexed: 01/07/2023] Open
Abstract
Variable clinical criteria taken by medical professionals across the world for myocarditis following coronavirus disease 2019 (COVID-19) vaccination along with wide variation in treatment necessitates understanding and reviewing the same. A systematic review was conducted to elucidate the clinical findings, laboratory parameters, treatment and outcomes of individuals with myocarditis after COVID-19 vaccination after registering with PROSPERO. Electronic databases including MEDLINE, EMBASE, PubMed, LitCovid, Scopus, ScienceDirect, Cochrane Library, Google Scholar and Web of Science were searched. A total of 85 articles encompassing 2184 patients were analysed. It was a predominantly male (73.4%) and young population (mean age: 25.5 ± 14.2 years) with most having taken an mRNA-based vaccine (99.4%). The mean duration from vaccination to symptom onset was 4.01 ± 6.99 days. Chest pain (90.1%), dyspnoea (25.7%) and fever (11.9%) were the most common symptoms. Only 2.3% had comorbidities. CRP was elevated in 83.3% and cardiac troponin in 97.6% patients. An abnormal ECG was reported in 979/1313 (74.6%) patients with ST-segment elevation being most common (34.9%). Echocardiographic data were available for 1243 patients (56.9%), of whom 288 (23.2%) had reduced left ventricular ejection fraction. Non-steroidal antiinflammatory drugs (76.5%), steroids (14.1%) followed by colchicine (7.3%) were used for treatment. Only 6 patients died among 1317 of whom data were available. Myocarditis following COVID-19 vaccination is often mild, seen more commonly in young healthy males and is followed by rapid recovery with conservative treatment. The emergence of this adverse event calls for harmonizing case definitions and definite treatment guidelines, which require wider research.
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Affiliation(s)
- Medha Goyal
- Department of Neonatology, Seth GSMC & KEMH, India, Mumbai
| | - Ishita Ray
- Department of Medicine, Mahatma Gandhi Memorial Medical College, Indore, Madhya Pradesh, India
| | | | - Shekhar Kunal
- Department of Cardiology, ESIC Medical College & Hospital Faridabad, India
| | - Ruchi Arora Sachdeva
- Department of Respiratory Medicine, ESIC Medical College & Hospital Faridabad, India
| | - Pranav Ish
- Corresponding author: Dr Pranav Ish, Assistant Professor, Department of Pulmonary and Critical Care Medicine, Room number 638. Superspeciality Block, Vardhman Mahavir Medical College and Safdarjung Hospital, Delhi 110029, India. , Phone- +91-9958356000
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8
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Abstract
OBJECTIVES The discovery and subsequent manufacture of various types of COVID-19 vaccines were considered a breakthrough in the fight against the COVID-19 pandemic. Initially, limited supplies of COVID-19 vaccines warranted vulnerable populations such as people living with chronic non-communicable diseases and the elderly to be prioritised for vaccination. Nevertheless, the uptake of the COVID-19 vaccines among these populations was suboptimal. In this study, we aimed to describe the drivers of COVID-19 vaccine hesitancy among people living with chronic non-communicable diseases in Ibadan, Nigeria. METHOD We applied qualitative methods to explore the feelings and thoughts of people living with chronic non-communicable diseases towards COVID-19 vaccines, at a tertiary hospital in Ibadan, Nigeria. Data were obtained from 25 people living with chronic conditions through in-depth interviews. We thematically analysed the transcripts inductively and deductively. Dedoose qualitative data management software was used to manage the data. FINDINGS Emerging subthemes were grouped into two major themes: Hesitancy towards the COVID-19 vaccine related to biological concerns and those related to sociopolitical issues. Hesitancy towards the COVID-19 vaccine associated with biological factors included: (1) concerns over the COVID-19 vaccine worsening the underlying chronic condition; (2) fear of harmful physiological consequences; (3) concerns over insufficient testing of vaccine for safety and (4) perceived vaccine infectiveness. Sociopolitical factors were related to (1) misconceptions of vaccines as a treatment for those with COVID-19; (2) mistrust of manufacturers ('the whites'); (3) mistrust of government and (4) COVID-19 misinformation. CONCLUSION Public health education on the nature and benefits of the COVID-19 vaccine is urgently needed among people living with chronic non-communicable diseases. These measures could improve COVID-19 vaccine uptake and healthcare usage in general. Paying attention to these factors could have implications for the management of the next global pandemic requiring mass vaccination.
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Affiliation(s)
- Lucia Y Ojewale
- Department of Nursing, University of Ibadan, Ibadan, Oyo State, Nigeria
| | - Ferdinand C Mukumbang
- School of Public Health, University of the Western Cape, Bellville, South Africa
- Department of Global Health, University of Washington Seattle Campus, Seattle, Washington, USA
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Badaró R, Novaes G, Andrade AC, de Araujo Neto CA, Machado BA, Barbosa JDV, Soares MBP. Myocardial infarction or myocarditis? A case report and review of a myocardial adverse event associated with mRNA vaccine. Front Med (Lausanne) 2023; 10:1071239. [PMID: 36817791 PMCID: PMC9932914 DOI: 10.3389/fmed.2023.1071239] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 01/02/2023] [Indexed: 02/05/2023] Open
Abstract
A 23-year-old man started with chest pain 8 h after his first Pfizer-BioNTech COVID-19 vaccination. ECG evaluation showed sinus tachycardia with ST-segment elevation in D1, AVL, V5, and V6, the findings compatible with acute subepicardial myocardial damage. However, cardiac MRI documented myocardial fibrosis, with cardiac late enhancement non-ischemic pattern with diffuse edema. He had no other symptoms to suggest another etiology than the vaccination. The patient was hospitalized and received corticosteroid (prednisolone) daily. Then, 2 weeks after hospitalization, all laboratory parameters and ECG were normal and the patient was discharged from the hospital. The patient had a history of Wolf-Parkinson White that was corrected with ablation when he was 11 years old. This report calls attention to myocardial adverse reaction risk for mRNA COVID-19 vaccines for people with a previous cardiac disease history.
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Affiliation(s)
- Roberto Badaró
- SENAI Institute of Innovation (ISI) in Health Advanced Systems, University Center SENAI/CIMATEC, Salvador, Brazil,Allmed Specialized Clinic, Salvador, Brazil,*Correspondence: Roberto Badaró,
| | | | | | | | - Bruna Aparecida Machado
- SENAI Institute of Innovation (ISI) in Health Advanced Systems, University Center SENAI/CIMATEC, Salvador, Brazil
| | - Josiane Dantas Viana Barbosa
- SENAI Institute of Innovation (ISI) in Health Advanced Systems, University Center SENAI/CIMATEC, Salvador, Brazil
| | - Milena Botelho Pereira Soares
- SENAI Institute of Innovation (ISI) in Health Advanced Systems, University Center SENAI/CIMATEC, Salvador, Brazil,Gonçalo Moniz Institute, Oswaldo Cruz Foundation (FIOCRUZ), Salvador, Brazil,Milena Botelho Pereira Soares,
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10
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Paknahad MH, Yancheshmeh FB, Soleimani A. Cardiovascular complications of COVID-19 vaccines: A review of case-report and case-series studies. Heart Lung 2023; 59:173-180. [PMID: 36842342 PMCID: PMC9905103 DOI: 10.1016/j.hrtlng.2023.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 01/24/2023] [Accepted: 02/05/2023] [Indexed: 02/10/2023]
Abstract
BACKGROUND There are multiple reviews on cardiovascular aspects of COVID-19 disease on cardiovascular system in different population but there is lack of evidence about cardiovascular adverse effects of COVID vaccines. OBJECTIVES The purpose of this study was to compare the cardiac complications of COVID19 vaccines, based on vaccine type (mRNA, vector-based, and inactivated vaccines). METHODS A systematic search was performed covering PubMed for English case-reports and case-series studies, and finally 100 studies were included. RESULTS Myocarditis (with overall rate around 1.62%) was shown to be the most common post-COVID19 immunization cardiac event. More than 90% of post-COVID19 vaccination myocarditis occurred after receiving mRNA vaccines (Moderna & Pfizer-BioNTech), but the report of this event was less in the case of vector-based vaccinations and/or inactivated vaccines. Myocarditis was reported more commonly in men and following the second dose of the immunization. Takotsubo cardiomyopathy (TTC) was reported after mRNA (more commonly) and vector-based vaccinations, with no case report after inactivated vaccines. When mRNA and vector-based vaccinations were used instead of inactivated vaccines, a greater frequency of vaccine-induced thrombotic thrombocytopenia (VITT) and pulmonary emboli (PE) was reported. Myocardial infarction/cardiac arrest was recorded in those beyond the age of 75 years. CONCLUSION The personal and public health benefits of COVID-19 vaccination much outweigh the minor cardiac risks. Reporting bias, regarding more available mRNA vaccines in developed countries, may conflict these results.
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Affiliation(s)
- Mohammad Hossein Paknahad
- Cardiologist, Cardiology Department, Chamran Cardiovascular Medical and Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatereh Baharlouei Yancheshmeh
- Cardiologist, Cardiology Department, Chamran Cardiovascular Medical and Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azam Soleimani
- Associate Professor of Cardiology, Echocardiologist, Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; Echocardiography Department, Chamran Cardiovascular Medical and Research Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
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11
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AL-Qudah BM, Abdalla ELM, Albazoon F, Habib MB, Elzouki ANY. Severe Myocarditis in a Female Following mRNA-1273 Vaccine: A Case Report and Review of the Literature. Cureus 2022. [DOI: 10.7759/cureus] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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12
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AL-Qudah BM, Abdalla ELM, Albazoon F, Habib MB, Elzouki ANY. Severe Myocarditis in a Female Following mRNA-1273 Vaccine: A Case Report and Review of the Literature. Cureus 2022; 14:e29299. [PMID: 36277556 PMCID: PMC9578725 DOI: 10.7759/cureus.29299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 11/05/2022] Open
Abstract
Myocarditis was recently described as one of the complications secondary to COVID-19 vaccination. We present a 38-year-old lady diagnosed with vaccine-related myocarditis a few days after receiving the mRNA-1273 vaccine. We also summarize what is reported in the literature about the association between COVID-19 vaccination and myocarditis. In conclusion, COVID-19 immunization appears to be associated with significantly fewer adverse outcomes than COVID-19 infection among all age groups.
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13
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Voltarelli CL, Silva L, Longo M, Ferraria S, Martins LL, Nazar G, Magalhães T, Miyazima R, Lenci Marques G. COVID-19-Induced Myocarditis and mRNA Vaccine-Related Pericarditis: A Case Report. Cureus 2022; 14:e28440. [PMID: 36176830 PMCID: PMC9509695 DOI: 10.7759/cureus.28440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 11/25/2022] Open
Abstract
Acute inflammatory cardiac disease is an increasing cause of COVID-19 vaccine-induced complications. We report a case of acute pericarditis following the second dose of the COVID-19 vaccine (BNT162b2) in a 49-year-old woman with previous COVID-19-induced myocarditis and heart failure. A clinical presentation compatible with acute decompensated heart failure elevated troponin levels and a cardiac-MRI showing myocardial fibrosis and inflammatory pericardial effusion led to the diagnosis of perimyocarditis. She was treated with non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine. Her condition improved in eight days. Physicians should be aware of the possible diagnosis of pericarditis and/or a myocardial injury after COVID-19 infection and vaccination.
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14
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Watts C, Nadori K. Elevated transaminases and development of cardiomyopathy in a 32-year-old woman with metastatic breast cancer after treatment with ribociclib followed by palbociclib. J Oncol Pharm Pract 2022:10781552221122057. [PMID: 36000297 DOI: 10.1177/10781552221122057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Cyclin-dependent kinase 4 and 6 inhibitors, ribociclib and palbociclib, are associated with reports of transaminitis and adverse cardiac events. CASE REPORT The patient is a previously healthy 32-year-old female diagnosed with estrogen receptor-positive, progesterone receptor-positive, and human epidermal growth factor 2 negative metastatic breast cancer. From July to September 2021, the patient was initiated on ribociclib followed by palbociclib for metastatic breast cancer. She subsequently experienced two episodes of transaminitis and was diagnosed with cardiomyopathy. MANAGEMENT AND OUTCOME The patient experienced transaminitis 2 weeks after the initiation of ribociclib resulting in discontinuation. When rechallenged with palbociclib, the patient experienced transaminitis within 1 week of initiation, which resulted in discontinuation. Approximately 1 month after palbociclib discontinuation, the patient was diagnosed with congestive heart failure with a left ventricular ejection fraction of 24%. DISCUSSION To our knowledge, there are few case studies investigating cyclin-dependent kinase 4 and 6 inhibitor rechallenge following transaminitis. Prior literature suggests that transaminitis with cyclin-dependent kinase 4 and 6 inhibitors is not a class effect, but this case report suggests otherwise. This report presents a rare case of cardiomyopathy and transaminitis following the administration of cyclin-dependent kinase 4 and 6 inhibitors, ribociclib and palbociclib.
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Affiliation(s)
- Christina Watts
- Tom Baker Cancer Centre, 3146Alberta Health Services, Calgary, Canada.,Faculty of Pharmacy and Pharmaceutical Sciences, 3158University of Alberta, Edmonton, Canada
| | - Karin Nadori
- Tom Baker Cancer Centre, 3146Alberta Health Services, Calgary, Canada
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15
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Matar RH, Mansour R, Nakanishi H, Smayra K, El Haddad J, Vankayalapati DK, Daniel RS, Tosovic D, Than CA, Yamani MH. Clinical Characteristics of Patients with Myocarditis following COVID-19 mRNA Vaccination: A Systematic Review and Meta-Analysis. J Clin Med 2022; 11:jcm11154521. [PMID: 35956137 PMCID: PMC9369856 DOI: 10.3390/jcm11154521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 12/10/2022] Open
Abstract
COVID-19 mRNA vaccinations have recently been implicated in causing myocarditis. Therefore, the primary aim of this systematic review and meta-analysis was to investigate the clinical characteristics of patients with myocarditis following mRNA vaccination. The secondary aims were to report common imaging and laboratory findings, as well as treatment regimes, in these patients. A literature search was performed from December 2019 to June 2022. Eligible studies reported patients older than 18 years vaccinated with mRNA, a diagnosis of myocarditis, and subsequent outcomes. Pooled mean or proportion were analyzed using a random-effects model. Seventy-five unique studies (patient n = 188, 89.4% male, mean age 18–67 years) were included. Eighty-six patients had Moderna vaccines while one hundred and two patients had Pfizer-BioNTech vaccines. The most common presenting symptoms were chest pain (34.5%), fever (17.1%), myalgia (12.4%), and chills (12.1%). The most common radiologic findings were ST-related changes on an electrocardiogram (58.7%) and hypokinesia on cardiac magnetic resonance imaging or echocardiography (50.7%). Laboratory findings included elevated Troponin I levels (81.7%) and elevated C-reactive protein (71.5%). Seven patients were admitted to the intensive care unit. The most common treatment modality was non-steroid anti-inflammatory drugs (36.6%) followed by colchicine (28.5%). This meta-analysis presents novel evidence to suggest possible myocarditis post mRNA vaccination in certain individuals, especially young male patients. Clinical practice must therefore take appropriate pre-cautionary measures when administrating COVID-19 mRNA vaccinations.
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Affiliation(s)
- Reem H. Matar
- Faculty of Medicine, St George’s University of London, London SW17 0RE, UK; (R.M.); (H.N.); (K.S.); (J.E.H.); (D.K.V.); (R.S.D.); (C.A.T.)
- Faculty of Medicine, University of Nicosia Medical School, University of Nicosia, Nicosia 2417, Cyprus
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN 55905, USA
- Correspondence:
| | - Rania Mansour
- Faculty of Medicine, St George’s University of London, London SW17 0RE, UK; (R.M.); (H.N.); (K.S.); (J.E.H.); (D.K.V.); (R.S.D.); (C.A.T.)
- Faculty of Medicine, University of Nicosia Medical School, University of Nicosia, Nicosia 2417, Cyprus
| | - Hayato Nakanishi
- Faculty of Medicine, St George’s University of London, London SW17 0RE, UK; (R.M.); (H.N.); (K.S.); (J.E.H.); (D.K.V.); (R.S.D.); (C.A.T.)
- Faculty of Medicine, University of Nicosia Medical School, University of Nicosia, Nicosia 2417, Cyprus
| | - Karen Smayra
- Faculty of Medicine, St George’s University of London, London SW17 0RE, UK; (R.M.); (H.N.); (K.S.); (J.E.H.); (D.K.V.); (R.S.D.); (C.A.T.)
- Faculty of Medicine, University of Nicosia Medical School, University of Nicosia, Nicosia 2417, Cyprus
| | - Joe El Haddad
- Faculty of Medicine, St George’s University of London, London SW17 0RE, UK; (R.M.); (H.N.); (K.S.); (J.E.H.); (D.K.V.); (R.S.D.); (C.A.T.)
- Faculty of Medicine, University of Nicosia Medical School, University of Nicosia, Nicosia 2417, Cyprus
| | - Dilip K. Vankayalapati
- Faculty of Medicine, St George’s University of London, London SW17 0RE, UK; (R.M.); (H.N.); (K.S.); (J.E.H.); (D.K.V.); (R.S.D.); (C.A.T.)
- Faculty of Medicine, University of Nicosia Medical School, University of Nicosia, Nicosia 2417, Cyprus
| | - Rohan Suresh Daniel
- Faculty of Medicine, St George’s University of London, London SW17 0RE, UK; (R.M.); (H.N.); (K.S.); (J.E.H.); (D.K.V.); (R.S.D.); (C.A.T.)
- Faculty of Medicine, University of Nicosia Medical School, University of Nicosia, Nicosia 2417, Cyprus
| | - Danijel Tosovic
- School of Biomedical Sciences, The University of Queensland, St. Lucia, Brisbane 4072, Australia;
| | - Christian A. Than
- Faculty of Medicine, St George’s University of London, London SW17 0RE, UK; (R.M.); (H.N.); (K.S.); (J.E.H.); (D.K.V.); (R.S.D.); (C.A.T.)
- Faculty of Medicine, University of Nicosia Medical School, University of Nicosia, Nicosia 2417, Cyprus
- School of Biomedical Sciences, The University of Queensland, St. Lucia, Brisbane 4072, Australia;
| | - Mohamad H. Yamani
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL 32224, USA;
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16
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Keshavarz P, Yazdanpanah F, Emad M, Hajati A, Nejati SF, Ebrahimian Sadabad F, Azrumelashvili T, Mizandari M, Raman SS. Myocarditis Following COVID-19 Vaccination: Cardiac Imaging Findings in 118 Studies. Tomography 2022; 8:1959-1973. [PMID: 36006062 PMCID: PMC9416085 DOI: 10.3390/tomography8040164] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/19/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
We reviewed the reported imaging findings of myocarditis in the literature following COVID-19 vaccination on cardiac imaging by a literature search in online databases, including Scopus, Medline (PubMed), Web of Science, Embase (Elsevier), and Google Scholar. In total, 532 cases of myocarditis after COVID-19 vaccination were reported (462, 86.8% men and 70, 13.2% women, age range 12 to 80) with the following distribution: Pfizer-BioNTech: 367 (69%), Moderna: 137 (25.8%), AstraZeneca: 12 (2.3%), Janssen/Johnson & Johnson: 6 (1.1%), COVAXIN: 1 (0.1%), and unknown mRNA vaccine: 9 (1.7%). The distribution of patients receiving vaccine dosage was investigated. On cardiac MR Imaging, late intravenous gadolinium enhancement (LGE) was observed mainly in the epicardial/subepicardial segments (90.8%, 318 of 350 enhancing segments), with the dominance of inferolateral segment and inferior walls. Pericardial effusion was reported in 13.1% of cases. The vast majority of patients (94%, 500 of 532) were discharged from the hospital except for 4 (0.7%) cases. Post-COVID-19 myocarditis was most commonly reported in symptomatic men after the second or third dose, with CMRI findings including LGE in 90.8% of inferior and inferolateral epicardial/subepicardial segments. Most cases were self-limited.
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Affiliation(s)
- Pedram Keshavarz
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA; (P.K.); (S.S.R.)
- School of Science and Technology, The University of Georgia, Tbilisi 0171, Georgia
| | - Fereshteh Yazdanpanah
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tabriz 5166, Iran;
| | - Maryam Emad
- Taba Medical Imaging Center, Shiraz 71347-53151, Iran; (M.E.); (A.H.); (S.F.N.); (F.E.S.)
| | - Azadeh Hajati
- Taba Medical Imaging Center, Shiraz 71347-53151, Iran; (M.E.); (A.H.); (S.F.N.); (F.E.S.)
| | - Seyed Faraz Nejati
- Taba Medical Imaging Center, Shiraz 71347-53151, Iran; (M.E.); (A.H.); (S.F.N.); (F.E.S.)
| | | | - Tamta Azrumelashvili
- Department of Diagnostic & Interventional Radiology, New Hospitals Ltd., Tbilisi 0114, Georgia;
| | - Malkhaz Mizandari
- Department of Diagnostic & Interventional Radiology, New Hospitals Ltd., Tbilisi 0114, Georgia;
| | - Steven S. Raman
- Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA; (P.K.); (S.S.R.)
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17
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Federspiel JM, Ramsthaler F, Kettner M, Mall G. Diagnostics of messenger ribonucleic acid (mRNA) severe acute respiratory syndrome-corona virus‑2 (SARS-CoV‑2) vaccination-associated myocarditis—A systematic review. Rechtsmedizin (Berl) 2022; 33:125-131. [PMID: 35873498 PMCID: PMC9297279 DOI: 10.1007/s00194-022-00587-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 12/15/2022]
Abstract
Background Objective Methods Results Conclusion Supplementary Information
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Affiliation(s)
- Jan M. Federspiel
- Institute of Legal Medicine, Saarland University, Campus Homburg, Kirrbergerstraße, Geb. 49.1, 66421 Homburg Saar, Germany
| | - Frank Ramsthaler
- Institute of Legal Medicine, Saarland University, Campus Homburg, Kirrbergerstraße, Geb. 49.1, 66421 Homburg Saar, Germany
| | - Mattias Kettner
- Institute of Legal Medicine, Goethe University Frankfurt Main, Kennedyallee 104, 60596 Frankfurt Main, Germany
| | - Gerhard Mall
- Medical Care Center for Clinical Pathology, Grafenstraße 9, 64283 Darmstadt, Germany
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18
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Sharma K, Patel S, Patel Z, Patel KB, Doshi JS, Shah DB, Chokshi P, Parbatani A, Sharma C, Patel A, Konat A. A Comprehensive Analysis of Myocarditis in Formerly Healthy Individuals Following SARS-CoV-2 Vaccination (COVID-19 Immunization). Cureus 2022; 14:e26851. [PMID: 35974860 PMCID: PMC9375127 DOI: 10.7759/cureus.26851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 12/21/2022] Open
Abstract
Due to the rapid development of the coronavirus disease 2019 (COVID-19) pandemic, the Food and Drug Administration (FDA) expedited the authorization of immunizations to counteract life-threatening COVID-19 effects. COVID-19 immunization was seen as an essential component of surviving endemically with COVID-19. Although there were no major adverse event reports that mandated an early authorization of the mass vaccination approval in initial studies, a few significant adverse events were reported after real-world usage. The most prevalent adverse events are regional reactions, such as discomfort at the injection site. Anaphylactic shock and acute responses were quite infrequent. Current evidence strongly convince the community that the advantages of immunization outweigh the risks. The review investigates the potential adverse reaction in the form of myocarditis caused by the COVID-19 vaccine. Age, sexuality, vaccination type, clinical manifestations, and diagnostic modalities were among the confounding factors associated with vaccine-induced myocarditis. This picture depicts COVID-19 immunization-induced myocarditis and the treatment options available to practitioners. Further evaluation is needed to establish the underlying cause of this association. We compiled the most recent data on SARS-CoV-2 vaccine-induced myocarditis after reviewing available research. Information sources including PubMed and Google Scholar were evaluated retrospectively.
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19
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Behers BJ, Patrick GA, Jones JM, Carr RA, Behers BM, Melchor J, Rahl DE, Guerriero TD, Zhang H, Ozkardes C, Thomas ND, Sweeney MJ. Myocarditis Following COVID-19 Vaccination: A Systematic Review of Case Reports. THE YALE JOURNAL OF BIOLOGY AND MEDICINE 2022; 95:237-247. [PMID: 35782472 PMCID: PMC9235262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Introduction: COVID-19, the infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), often presents with a spectrum of symptoms at varying levels of severity, ranging from asymptomatic patients to those with fatal complications, such as myocarditis. With increased availability of COVID-19 vaccines, the awareness of possible side effects has expanded as reports surface. This study reviewed cases of myocarditis following COVID-19 vaccination and with existing literature on COVID-19 infection-induced myocarditis to compare clinical courses and analyze possible mechanisms of action. Methods: A systematic review of literature was conducted to identify published case reports (as of February 3, 2022) pertaining to the development of myocarditis following COVID-19 vaccination with either Pfizer or Moderna for an in-depth analysis. Additional subgroup analyses were conducted based on age, past medical history, vaccine manufacturer, and dose number. Results: There were 53 eligible case reports that were included in this study. Patients were mostly male with a median age of 24 years, and the most reported symptom upon presentation was chest pain. Seventy percent of the cases involved the Pfizer vaccine with a majority of myocarditis developing subsequent to second dose. Resolution of symptoms was achieved in all but one patient. Clinical severity, as measured primarily by left ventricular ejection fraction, appeared to be worse among adult patients than pediatric, as well as for patients with comorbidities. Conclusion: This study revealed an observable association between COVID-19 vaccines and myocarditis. However, the clinical course and prognosis seem favorable and less prevalent than those conferred from natural infection.
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Affiliation(s)
- Benjamin J. Behers
- Florida State University College of Medicine,
Tallahassee, FL, USA,To whom all correspondence should be addressed:
Benjamin J. Behers, Florida State University College of Medicine, Tallahassee,
FL;
| | | | - Jared M. Jones
- Florida State University College of Medicine,
Tallahassee, FL, USA
| | - Rachel A. Carr
- Florida State University College of Medicine,
Tallahassee, FL, USA
| | - Brett M. Behers
- University of South Florida College of Medicine, Tampa,
FL, USA
| | - Julian Melchor
- Florida State University College of Medicine,
Tallahassee, FL, USA
| | - Delaney E. Rahl
- Florida State University College of Medicine,
Tallahassee, FL, USA
| | | | | | - Cuneyt Ozkardes
- Florida State University College of Medicine,
Tallahassee, FL, USA
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20
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Temporal Association Between the COVID-19 Ad26.COV2.S Vaccine and Acute Myocarditis: A Case Report and Literature Review. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2022; 38:117-123. [PMID: 34420869 PMCID: PMC8364889 DOI: 10.1016/j.carrev.2021.08.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/05/2021] [Accepted: 08/09/2021] [Indexed: 02/07/2023]
Abstract
With the recent approval and widespread administration of the Pfizer-BioNTech, Moderna, and Janssen vaccines worldwide, incidence of severe Coronavirus Disease 2019 (COVID-19) infection has significantly decreased. In spite of their undisputed role in reducing the severity of the disease and reduction of the disease burden in the community, there have been case reports of serious side effects with these vaccines. We aim to describe a case report of myocarditis following administration of the Janssen vaccine in a healthy, young male and review the available literature on COVID-19 vaccine related myocarditis and its possible pathogenesis. This case and literature review notes a temporal association between COVID-19 vaccination and myocarditis. Despite these observations, the benefits of the vaccines far outweigh the risks of possible myocarditis.
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21
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Parmar K, Subramanyam S, Del Rio-Pertuz G, Sethi P, Argueta-Sosa E. Cardiac Adverse Events after Vaccination—A Systematic Review. Vaccines (Basel) 2022; 10:vaccines10050700. [PMID: 35632455 PMCID: PMC9143985 DOI: 10.3390/vaccines10050700] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/12/2022] [Accepted: 04/20/2022] [Indexed: 01/27/2023] Open
Abstract
The Vaccine Adverse Event Reporting System database has been used to report adverse events following several vaccines. We studied the patient population predisposed to such reactions and how these reactions differ with respect to the vaccine type. We searched the electronic databases PubMed, EMBASE, and Scopus up to 9 July 2021 for any study describing cardiac adverse events attributed to the vaccination. A total of 56 studies met the criteria comprising 340 patients. There were 20 studies describing cardiac adverse events following smallpox vaccination, 11 studies describing adverse events after influenza vaccination, and 18 studies describing adverse events after COVID-19 vaccination. There was a total of six studies describing cardiac adverse events after the pneumococcal vaccine, tetanus toxoid, cholera vaccine, and rabies vaccine. Adverse events following influenza vaccination occurred more commonly in older females within an average duration of four days from vaccination. Pericardial involvement was the most reported adverse event. Adverse events following COVID-19 vaccination happened at a mean age of 42.7 years, more commonly in males, and mostly after a second dose. Adverse events following smallpox vaccination occurred more commonly in younger males, with an average onset of symptoms from vaccination around 16.6 days. Adverse events were mostly myopericarditis; however, the acute coronary syndrome has been reported with some vaccines.
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Affiliation(s)
- Kanak Parmar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA;
- Correspondence:
| | - Sai Subramanyam
- School of Medicine, Vydehi Institute of Medical Sciences and Research Centre, Bangalore 560048, India;
| | - Gaspar Del Rio-Pertuz
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA;
| | - Pooja Sethi
- Department of Cardiovascular Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; (P.S.); (E.A.-S.)
| | - Erwin Argueta-Sosa
- Department of Cardiovascular Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; (P.S.); (E.A.-S.)
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22
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Woo W, Kim AY, Yon DK, Lee SW, Hwang J, Jacob L, Koyanagi A, Kim MS, Moon DH, Jung JW, Choi JY, Jung SY, Eun LY, Lee S, Shin JI, Smith L. Clinical characteristics and prognostic factors of myocarditis associated with the mRNA COVID-19 vaccine. J Med Virol 2022; 94:1566-1580. [PMID: 34862617 PMCID: PMC9015469 DOI: 10.1002/jmv.27501] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 11/23/2021] [Accepted: 12/01/2021] [Indexed: 02/05/2023]
Abstract
To analyze the clinical presentation and outcomes of myocarditis after administration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) messenger RNA (mRNA) vaccine. Nine case series and 15 case reports (74 patients) of myocarditis after administration of the BNT162b2 or mRNA-1273 vaccine were reviewed from PubMed, Scopus, Embase, and Web of Science. We analyzed clinical manifestations, diagnostic findings, and outcomes. In addition, we performed a pooled analysis and investigated risk factors leading to admission to the intensive care unit and recovery with conservative care. Most patients were male (94.6%), and the median age (range) was 17.6 (14-70) years. Patients who received the BNT162b2 (n = 58, 78.4%) vaccine presented fewer systemic symptoms and left ventricular dysfunction than mRNA-1273 recipients. Although patients under 20 years experienced more fever and myalgia, they had better ejection fraction and less prominent myocardial inflammation in magnetic resonance imaging than older patients. The clinical course of all patients was favorable without mortality, and one-third of patients resolved with conservative care alone. Risk factor analyses revealed that patients with gastrointestinal symptoms required intensive care (odds ratio: 20.3, 95% confidence interval 1.90-217, p = 0.013). The risk of fatality in myocarditis subjected to mRNA vaccination seems to be low. However, patients with gastrointestinal symptoms received more intensive care, and a significant proportion of patients recovered with conservative management.
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Affiliation(s)
- Wongi Woo
- Department of Thoracic and Cardiovascular SurgeryGangnam Severance Hospital, Yonsei University College of MedicineSeoulKorea
| | - Ah Y. Kim
- Department of PediatricsYonsei University College of MedicineSeoulKorea
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular HospitalYonsei University College of MedicineSeoulKorea
| | - Dong K. Yon
- Department of PediatricsSeoul National University Hospital, Seoul National University College of MedicineSeoulSouth Korea
| | - Seung W. Lee
- Department of Data ScienceSejong University College of Software ConvergenceSeoulSouth Korea
| | - Jimin Hwang
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
| | - Louis Jacob
- Parc Sanitari Sant Joan de Deu/CIBERSAM, Fundacio Sant Joan de Deu, Sant Boi de LlobregatUniversitat de BarcelonaBarcelonaSpain
- Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Samsung Medical Center, Sungkyunkwan UniversitySeoulRepublic of Korea
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Deu/CIBERSAM, Fundacio Sant Joan de Deu, Sant Boi de LlobregatUniversitat de BarcelonaBarcelonaSpain
- Faculty of Medicine, University of Versailles Saint‐Quentin‐en‐YvelinesMontigny‐le‐BretonneuxFrance
| | - Min S. Kim
- ICREA, Pg. Lluis Companys 23BarcelonaSpain
| | - Duk H. Moon
- Department of Thoracic and Cardiovascular SurgeryGangnam Severance Hospital, Yonsei University College of MedicineSeoulKorea
| | - Jo W. Jung
- Department of PediatricsYonsei University College of MedicineSeoulKorea
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular HospitalYonsei University College of MedicineSeoulKorea
| | - Jae Y. Choi
- Department of PediatricsYonsei University College of MedicineSeoulKorea
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular HospitalYonsei University College of MedicineSeoulKorea
| | - Se Y. Jung
- Department of PediatricsYonsei University College of MedicineSeoulKorea
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular HospitalYonsei University College of MedicineSeoulKorea
| | - Lucy Y. Eun
- Department of PediatricsYonsei University College of MedicineSeoulKorea
- Division of Pediatric Cardiology, Department of Pediatrics, Severance Cardiovascular HospitalYonsei University College of MedicineSeoulKorea
| | - Sungsoo Lee
- Department of Thoracic and Cardiovascular SurgeryGangnam Severance Hospital, Yonsei University College of MedicineSeoulKorea
| | - Jae Il Shin
- Department of PediatricsYonsei University College of MedicineSeoulKorea
| | - Lee Smith
- Cambridge Centre for Health, Performance, and WellbeingAnglia Ruskin UniversityCambridgeUK
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23
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Han T, Ma W, Zhang Y, Wang C. Be Alert to the Risk of Adverse Cardiovascular Events after COVID-19 Vaccination. EXPLORATORY RESEARCH AND HYPOTHESIS IN MEDICINE 2022; 7:64-67. [DOI: 10.14218/erhm.2021.00033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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24
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Cavazos A, Deb A, Sharma U, Nugent K. COVID toes following vaccination. Proc AMIA Symp 2022; 35:476-479. [PMID: 35754589 PMCID: PMC9196769 DOI: 10.1080/08998280.2022.2043732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Cutaneous manifestations of COVID-19 infections include "COVID toes." These are pernio-like, pale purple, painful, ill-defined cyanotic lesions that have inflammatory infiltrates on histologic studies. COVID toes can also develop following COVID vaccination. COVID toes was reported by 29 individuals to the Vaccine Adverse Event Reporting System maintained by the Centers for Disease Control and Prevention through May 25, 2021. The mean age of these individuals was 52 ± 18 years; 23 (79%) were women. They had received both mRNA vaccines and the adenovirus vector-based vaccine. This discoloration developed 4.5 ± 9.8 days following vaccination, usually after the first dose. Four individuals required hospitalization for systemic symptoms, and one died. This information indicates that some individuals develop important clinical syndromes following vaccination and suggests that some of the manifestations of COVID-19 infection represent immune responses and not necessarily active tissue infection.
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Affiliation(s)
- Annia Cavazos
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Anasua Deb
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Upama Sharma
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
| | - Kenneth Nugent
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas
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25
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Chen JH, Ikwuanusi IA, Bommu VJL, Patel V, Aujla H, Kaushik V, Cheriyath P. COVID-19 Vaccine-Related Myocarditis: A Descriptive Study of 40 Case Reports. Cureus 2022; 14:e21740. [PMID: 35251812 PMCID: PMC8887934 DOI: 10.7759/cureus.21740] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2022] [Indexed: 12/21/2022] Open
Abstract
After the surging rise in the Coronavirus disease 2019 (COVID-19) pandemic, the Food and Drug Administration (FDA) approved emergency approval of vaccinations to prevent life-threatening complications of COVID-19 infection. These vaccines are BNT162b2, mRNA-1273. Later, the FDA also approved JNJ-78436735. COVID-19 vaccination does not have major side effects, but there are some concerning adverse events reported right after vaccination. Myocarditis is one of them. Based on our analysis of 40 case reports, we are presenting the epidemiology and clinical picture of myocarditis related to the COVID-19 vaccine. Based on our analysis, we found that the majority of cases were seen in males with 90% predominance, and these cases were seen in the age group of 29.13 years old (mean, SD of 14.39 years). In 65% of cases, patients took the BNT162b2 vaccine; 30% of cases were reported with the mRNA-1273 vaccine; and 5% of cases with JNJ-78436735. Of all the cases, 80% of them are reported after the second dose of the vaccine with either Moderna or Pfizer. The characteristics of COVID-19 vaccine-related myocarditis were analyzed in this study. We identified several findings, ranging from age, gender, type of vaccination, presentation of symptoms, and diagnosis modality. This depicts the picture of COVID-19 vaccine-related myocarditis and what physicians should expect when dealing with the disease. Our analysis showed that more cases were reported after receiving the BNT162b2 vaccine compared to mRNA-1273 and JNJ-78436735 vaccines. Further research needs to be conducted to analyze the underlying cause of this association.
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Affiliation(s)
- Jia Hong Chen
- Internal Medicine, Hackensack Meridian Ocean Medical Center, Brick, USA
| | | | | | - Vraj Patel
- Internal Medicine, Hackensack Meridian Ocean Medical Center, Brick, USA
| | | | - Vishrut Kaushik
- Internal Medicine, Hackensack Meridian Ocean Medical Center, Brick, USA
| | - Pramil Cheriyath
- Internal Medicine, Hackensack Meridian Ocean Medical Center, Brick, USA
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Fatima M, Ahmed Cheema H, Ahmed Khan MH, Shahid H, Saad Ali M, Hassan U, Wahaj Murad M, Aemaz Ur Rehman M, Farooq H. Development of myocarditis and pericarditis after COVID-19 vaccination in adult population: A systematic review. Ann Med Surg (Lond) 2022; 76:103486. [PMID: 35291413 PMCID: PMC8912977 DOI: 10.1016/j.amsu.2022.103486] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/01/2022] [Accepted: 03/06/2022] [Indexed: 12/20/2022] Open
Abstract
Objectives A clear temporal relationship between myocarditis and pericarditis after COVID-19 vaccination has led to the belief that the vaccine may act as a trigger for these cardiologic complications. The aim of this systematic review is to explore the incidence, clinical presentation, management, and association between them. Methods We conducted a systematic literature search on Cochrane, MEDLINE, and EMBASE as per guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews). A total of 41 case reports and case series describing 97 patients, and 5 original articles describing 15,585,309 participants were selected as part of this review. Results Of the 97 reported cases describing vaccine-associated myocarditis/pericarditis, 67 (69%) patients received Pfizer-BioNTech and 25 (25.7%) received Moderna. The mean onset of symptoms after vaccine administration was 3.8 ± 4.5 days with three-quarters developing symptoms after the second dose. Chest pain (n = 88, 90%) and fever (n = 33, 34%) were the most common presenting complaints. Out of 97, 80 (82.5%) patients recovered while 4 (4.1%) patients expired. The pooled incidence of myocarditis and pericarditis extrapolated from original studies is 0.001% and 0.0004%, respectively. In the original studies, nearly all the cases of myocarditis and pericarditis were mild. Chest pain and fever were the most common presenting symptoms. Conclusion Myocarditis and pericarditis after the COVID-19 vaccine have been reported more in young adult males and are most likely to occur after the second dose of mRNA vaccines. The presentation is mild and the majority of the patients recover either completely or partially. Myocarditis and pericarditis have been reported after the COVID-19 vaccine. It is occurs more commonly in males as compared to females. Myocarditis and Pericarditis is more likely to occur after second dose of mRNA vaccine. The presentation is mild, and most of the patients recover either completely or partially. Autoimmunity (molecular mimicry) is thought to be the major pathological mediator.
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Yeo A, Kuek B, Lau M, Tan SR, Chan S. Post COVID-19 vaccine deaths - Singapore's early experience. Forensic Sci Int 2022; 332:111199. [PMID: 35078041 PMCID: PMC8767909 DOI: 10.1016/j.forsciint.2022.111199] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/20/2021] [Accepted: 01/17/2022] [Indexed: 02/06/2023]
Abstract
Singapore has been using mRNA vaccines developed by Pfizer-BioNTech and Moderna as part of the nation's COVID vaccination program since 30 December 2020. From 1 February 2021-30 June 2021, a total of 34 deaths that occurred within 72 h of the deceased receiving their COVID-19 vaccination were referred to the Forensic Medicine Division of the Health Sciences Authority of Singapore. Autopsies, histological sampling and ancillary investigations consisting of total tryptase level, Immunoglobulin E (IgE), and C-reactive Protein (CRP), were performed on 29 of these cases. Our study has shown no definite causative relationship between the mRNA vaccination and deaths of individuals who died within 72 h after receiving the vaccination, in particular with regards to anaphylactic reactions, myocarditis and pericarditis, and thrombotic complications. Further studies may consider increasing the incident time frame from 72 h to seven days post-vaccination or longer to include any potential delayed presentation of adverse effects.
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Affiliation(s)
- Audrey Yeo
- Forensic Medicine Division, Applied Sciences Group, Health Sciences Authority, Singapore.
| | - Benjamin Kuek
- Forensic Medicine Division, Applied Sciences Group, Health Sciences Authority, Singapore
| | - Mandy Lau
- Forensic Medicine Division, Applied Sciences Group, Health Sciences Authority, Singapore
| | - Shi Rui Tan
- Forensic Medicine Division, Applied Sciences Group, Health Sciences Authority, Singapore
| | - Shijia Chan
- Forensic Medicine Division, Applied Sciences Group, Health Sciences Authority, Singapore
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Beaudoin CA, Bartas M, Volná A, Pečinka P, Blundell TL. Are There Hidden Genes in DNA/RNA Vaccines? Front Immunol 2022; 13:801915. [PMID: 35211117 PMCID: PMC8860813 DOI: 10.3389/fimmu.2022.801915] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 01/14/2022] [Indexed: 02/02/2023] Open
Abstract
Due to the fast global spreading of the Severe Acute Respiratory Syndrome Coronavirus - 2 (SARS-CoV-2), prevention and treatment options are direly needed in order to control infection-related morbidity, mortality, and economic losses. Although drug and inactivated and attenuated virus vaccine development can require significant amounts of time and resources, DNA and RNA vaccines offer a quick, simple, and cheap treatment alternative, even when produced on a large scale. The spike protein, which has been shown as the most antigenic SARS-CoV-2 protein, has been widely selected as the target of choice for DNA/RNA vaccines. Vaccination campaigns have reported high vaccination rates and protection, but numerous unintended effects, ranging from muscle pain to death, have led to concerns about the safety of RNA/DNA vaccines. In parallel to these studies, several open reading frames (ORFs) have been found to be overlapping SARS-CoV-2 accessory genes, two of which, ORF2b and ORF-Sh, overlap the spike protein sequence. Thus, the presence of these, and potentially other ORFs on SARS-CoV-2 DNA/RNA vaccines, could lead to the translation of undesired proteins during vaccination. Herein, we discuss the translation of overlapping genes in connection with DNA/RNA vaccines. Two mRNA vaccine spike protein sequences, which have been made publicly-available, were compared to the wild-type sequence in order to uncover possible differences in putative overlapping ORFs. Notably, the Moderna mRNA-1273 vaccine sequence is predicted to contain no frameshifted ORFs on the positive sense strand, which highlights the utility of codon optimization in DNA/RNA vaccine design to remove undesired overlapping ORFs. Since little information is available on ORF2b or ORF-Sh, we use structural bioinformatics techniques to investigate the structure-function relationship of these proteins. The presence of putative ORFs on DNA/RNA vaccine candidates implies that overlapping genes may contribute to the translation of smaller peptides, potentially leading to unintended clinical outcomes, and that the protein-coding potential of DNA/RNA vaccines should be rigorously examined prior to administration.
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Affiliation(s)
- Christopher A. Beaudoin
- Department of Biochemistry, Sanger Building, University of Cambridge, Cambridge, United Kingdom
| | - Martin Bartas
- Department of Biology and Ecology, University of Ostrava, Ostrava, Czechia
| | - Adriana Volná
- Department of Physics, University of Ostrava, Ostrava, Czechia
| | - Petr Pečinka
- Department of Biology and Ecology, University of Ostrava, Ostrava, Czechia
| | - Tom L. Blundell
- Department of Biochemistry, Sanger Building, University of Cambridge, Cambridge, United Kingdom
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Bellos I, Karageorgiou V, Viskin D. Myocarditis following mRNA Covid-19 vaccination: a pooled analysis. Vaccine 2022; 40:1768-1774. [PMID: 35153093 PMCID: PMC8818354 DOI: 10.1016/j.vaccine.2022.02.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/22/2022] [Accepted: 02/02/2022] [Indexed: 12/15/2022]
Abstract
Background Methods Results Conclusions
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Mungmunpuntipantip R, Wiwanitkit V. CMR Imaging After Myocarditis Associated with mRNA COVID-19 Vaccine: Correspondence. Pediatr Cardiol 2022; 43:1401. [PMID: 35376967 PMCID: PMC8977430 DOI: 10.1007/s00246-022-02896-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 03/28/2022] [Indexed: 11/25/2022]
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Matta A, Kunadharaju R, Osman M, Jesme C, McMiller Z, Johnson EM, Matta D, Kallamadi R, Bande D. Clinical Presentation and Outcomes of Myocarditis Post mRNA Vaccination: A Meta-Analysis and Systematic Review. Cureus 2021; 13:e19240. [PMID: 34877217 PMCID: PMC8641964 DOI: 10.7759/cureus.19240] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Myocarditis is being increasingly reported as a potential complication of both Pfizer-BioNTech and Moderna vaccines for COVID-19. One thousand five hundred and twenty-two cases were reported as of September 02, 2021, as per CDC's (Centers for Disease Control) vaccine adverse event reporting system. Most of the published data is available in the form of case reports and series. There is a need to compile the demographic data, clinical features, and outcomes in these patients. Methods: A systematic search was conducted in PubMed, Embase, Web of science, and google scholar for published literature between January 01, 2020, and July 17, 2021. Individual data of 69 patients were pooled from 25 qualifying case reports and case series. RESULTS The median age of onset was 21 years. 92.7% of the patients were male. 76.8% of patients received the Pfizer-BioNTech vaccine, and 23.2% received the Moderna vaccine. 88.5% developed symptoms after the second dose. Patients were admitted to the hospital a median of three days post-vaccination. All the patients had chest pain and elevated troponin. The myocarditis was confirmed on cardiac MRI in 87% of the patients. Most of the patients had late gadolinium enhancement on MRI. The median length of stay was four days. All the reported patients recovered and were discharged. CONCLUSION Post-mRNA vaccination myocarditis is seen predominantly in young males within a few days after their second dose of vaccination. The pathophysiology of myocarditis is not well known. The prognosis is good as all the reported patients recovered. The presence of late gadolinium enhancement on cardiac MRI indicated myocardial necrosis/fibrosis and further studies are needed to establish the long-term prognosis of the condition.
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Affiliation(s)
- Abhishek Matta
- Internal Medicine, Sanford Health, Fargo, USA
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, USA
| | - Rajesh Kunadharaju
- Department of Pulmonary and Critical Care Medicine, University of Buffalo, Buffalo, USA
| | - Marcus Osman
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, USA
| | - Christy Jesme
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, USA
| | - Zachary McMiller
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, USA
| | - Erika M Johnson
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, USA
| | - Danielle Matta
- Internal Medicine, Sanford Health, Fargo, USA
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, USA
| | - Rekha Kallamadi
- Internal Medicine, Sanford Health, Fargo, USA
- Internal Medicine, University of North Dakota School of Medicine and Health Sciences, Fargo, USA
| | - Dinesh Bande
- Internal Medicine, University of North Dakota School of Medicine, Fargo, USA
- Internal Medicine, Sanford Health, Fargo, USA
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Sookaromdee P, Wiwanitkit V. Acute Myocardial Injury Following COVID-19 Vaccination. J Prim Care Community Health 2021; 12:21501327211039986. [PMID: 34392736 PMCID: PMC8371718 DOI: 10.1177/21501327211039986] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Kim IC, Kim H, Lee HJ, Kim JY, Kim JY. Cardiac Imaging of Acute Myocarditis Following COVID-19 mRNA Vaccination. J Korean Med Sci 2021; 36:e229. [PMID: 34402228 PMCID: PMC8369314 DOI: 10.3346/jkms.2021.36.e229] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/02/2021] [Indexed: 12/11/2022] Open
Abstract
Increasing rates of coronavirus disease 2019 (COVID-19) vaccination coverage will result in more vaccine-related side effects, including acute myocarditis. In Korea, we present a 24-year-old male with acute myocarditis following COVID-19 vaccination (BNT162b2). His chest pain developed the day after vaccination and cardiac biomarkers were elevated. Echocardiography showed minimal pericardial effusion but normal myocardial contractility. Electrocardiography revealed diffuse ST elevation in lead II, and V2-5. Cardiac magnetic resonance images showed the high signal intensity of T2- short tau inversion recovery image, the high value of T2 mapping sequence, and late gadolinium enhancement in basal inferior and inferolateral wall. It was presumed that COVID-19 mRNA vaccination was probably responsible for acute myocarditis. Clinical course of the patient was favorable and he was discharged without any adverse event.
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Affiliation(s)
- In Cheol Kim
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
- Department of Cardiology, School of Medicine & Institute of Medical Science, Keimyung University, Daegu, Korea
| | - Hyungseop Kim
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea.
| | - Hee Jeong Lee
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Ji Yoon Kim
- Division of Cardiology, Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea
| | - Jin Young Kim
- Department of Radiology, Keimyung University Dongsan Medical Center, Daegu, Korea
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