Symptomatology, prognosis and clinical findings of myocarditis as an adverse event of COVID-19 mRNA vaccine: a systematic review

Funding Acknowledgements Type of funding sources: None. Background Myocarditis, an inflammation of the myocardium in the absence of ischemic injury, may be caused by viruses, drugs, and vaccines. The Myocarditis following COVID-19 vaccinations is most commonly seen in young adult males and commonly after the second dose of the mRNA vaccine. It usually presents with chest pain, dyspnoea, palpitations but has a diverse clinical presentation and varied therapeutic response. We aim to systematically collate the symptomatology, prognosis, and clinical findings of COVID-19 vaccine adverse events causing Myocarditis. Method Following the PRISMA statement 2020, a systematic search was conducted to isolate confirmed cases of COVID-19 vaccine-induced Myocarditis. By applying the BOOLEAN logic, the following keywords were used: COVID-19, SARS-CoV-2, Myocarditis, Mortality. Four databases were searched from January 2021 through August 2021: PubMed, Science Direct, Google Scholar, and Cochrane Library;the reference lists of screened studies were searched as well (umbrella methodology). Results In total, 12 case reports, 10 case series and 1 cohort study with a total of 107 patients were included in the final analysis. A total of 101 male patients were recorded, and 6 were female showing male dominance. The mean age of all participants was 24.73 years(SD = 13.18), ranging from 14 to 70. The most common presenting symptoms were chest pain (47.66%), fever (35.51%), and myalgia (25.23%). Lab findings showed elevated Troponin I, CRP, and ESR levels in the majority of patients. ECG was abnormal in most of the patients, which include sinus rhythm (24%), ST-elevation (42.05%) and T wave inversion (13.08%). Echo findings include decreased Ejection fraction in 19.62% of patients while 13.08% of patients having a hypokinetic left ventricular wall. Further, CMR finding suggestive of confirmed myocarditis cases in 36% patients while rest are suspected one. Overall mortality(1.86%) was low among patients. Conclusion There is increasing evidence for Myocarditis as a rare adverse event of COVID-19 mRNA vaccination in young adults. This evidence is strongest amongst young male patients. The majority of the patients complain of chest pain and fever. In lab findings Troponin I, CRP and ESR are usually increased and ST elevation is common in the ECG. This entity is mainly treated with nonsteroidal anti-inflammatory drugs, Colchicine, Beta-blockers, ACE inhibitors, Steroids. However, prognosis and outcomes are favourable with a very low mortality rate.

Structural and functional integrity of decontaminated N95 respirators: Experimental results

With the recent emergence of highly transmissible variants of the novel coronavirus SARS-CoV-2, the demand for N95 respirators is expected to remain high. The extensive use of N95 respirators by the public is susceptible to demand?supply gaps and raises concern about their disposal, threatening the environment with a new kind of plastic pollution. Herein, we investigated the filtration performance of the N95 respirator by specifically analyzing the structure in the key filtration layers of meltblown nonwoven after decontamination with one and five cycles of liquid hydrogen peroxide, ultraviolet radiation, moist heat, and aqueous soap solution treatments. With the aid of X-ray microcomputed tomography (microCT) analysis, the local structural heterogeneity of the meltblown nonwoven has been unfolded and subsequently correlated with their filtration performance at a face velocity that matched with speaking conditions (?3.89 m/s). The filtration efficiency results of the N95 respirator remain unaltered after performing one cycle of treatment modalities (except autoclave).

Symptomatology, prognosis and clinical findings of myocarditis as an adverse event of COVID-19 mRNA vaccine: A systematic review

Background: Myocarditis, an inflammation of the myocardium in the absence of ischemic injury, may be caused by viruses, drugs, and vaccines. The Myocarditis following COVID-19 vaccinations is most commonly seen in young adult males and commonly after the second dose of the mRNA vaccine. It usually presents with chest pain, dyspnoea, palpitations but has a diverse clinical presentation and varied therapeutic response. We aim to systematically collate the symptomatology, prognosis, and clinical findings of COVID-19 vaccine adverse events causing Myocarditis. Method: Following the PRISMA statement 2020, a systematic search was conducted to isolate confirmed cases of COVID-19 vaccine-induced Myocarditis. By applying the BOOLEAN logic, the following keywords were used: COVID-19, SARS-CoV-2, Myocarditis, Mortality. Four databases were searched from January 2021 through August 2021: PubMed, Science Direct, Google Scholar, and Cochrane Library;the reference lists of screened studies were searched as well (umbrella methodology). Results: In total, 12 case reports, 10 case series and 1 cohort study with a total of 107 patients were included in the final analysis. A total of 101 male patients were recorded, and 6 were female showing male dominance. The mean age of all participants was 24.73 years(SD = 13.18), ranging from 14 to 70. The most common presenting symptoms were chest pain (47.66%), fever (35.51%), and myalgia (25.23%). Lab findings showed elevated Troponin I, CRP, and ESR levels in the majority of patients. ECG was abnormal in most of the patients, which include sinus rhythm (24%), ST-elevation (42.05%) and T wave inversion (13.08%). Echo findings include decreased Ejection fraction in 19.62% of patients while 13.08% of patients having a hypokinetic left ventricular wall. Further, CMR finding suggestive of confirmed myocarditis cases in 36% patients while rest are suspected one. Overall mortality(1.86%) was low among patients. Conclusion: There is increasing evidence for Myocarditis as a rare adverse event of COVID-19 mRNA vaccination in young adults. This evidence is strongest amongst young male patients. The majority of the patients complain of chest pain and fever. In lab findings Troponin I, CRP and ESR are usually increased and ST elevation is common in the ECG. This entity is mainly treated with nonsteroidal anti-inflammatory drugs, Colchicine, Beta-blockers, ACE inhibitors, Steroids. However, prognosis and outcomes are favourable with a very low mortality rate.