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Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination.
Kim, Han W; Jenista, Elizabeth R; Wendell, David C; Azevedo, Clerio F; Campbell, Michael J; Darty, Stephen N; Parker, Michele A; Kim, Raymond J.
  • Kim HW; Duke Cardiovascular Magnetic Resonance Center, Durham, North Carolina.
  • Jenista ER; Division of Cardiology, Duke University Medical Center, Durham, North Carolina.
  • Wendell DC; Duke Cardiovascular Magnetic Resonance Center, Durham, North Carolina.
  • Azevedo CF; Division of Cardiology, Duke University Medical Center, Durham, North Carolina.
  • Campbell MJ; Duke Cardiovascular Magnetic Resonance Center, Durham, North Carolina.
  • Darty SN; Division of Cardiology, Duke University Medical Center, Durham, North Carolina.
  • Parker MA; Duke Cardiovascular Magnetic Resonance Center, Durham, North Carolina.
  • Kim RJ; Division of Cardiology, Duke University Medical Center, Durham, North Carolina.
JAMA Cardiol ; 6(10): 1196-1201, 2021 10 01.
Article in English | MEDLINE | ID: covidwho-1286092
ABSTRACT
Importance Vaccine-associated myocarditis is an unusual entity that has been described for the smallpox vaccine, but only anecdotal case reports have been described for other vaccines. Whether COVID-19 vaccination may be linked to the occurrence of myocarditis is unknown.

Objective:

To describe a group of 7 patients with acute myocarditis over 3 months, 4 of whom had recent messenger RNA (mRNA) COVID-19 vaccination. Design, Setting, and

Participants:

All patients referred for cardiovascular magnetic resonance imaging at Duke University Medical Center were asked to participate in a prospective outcomes registry. Two searches of the registry database were performed first, to identify patients with acute myocarditis for the 3-month period between February 1 and April 30 for 2017 through 2021, and second, to identify all patients with possible vaccine-associated myocarditis for the past 20 years. Once patients with possible vaccine-associated myocarditis were identified, data available in the registry were supplemented by additional data collection from the electronic health record and a telephone interview. Exposures mRNA COVID-19 vaccine. Main Outcomes and

Measures:

Occurrence of acute myocarditis by cardiovascular magnetic resonance imaging.

Results:

In the 3-month period between February 1 and April 30, 2021, 7 patients with acute myocarditis were identified, of which 4 occurred within 5 days of COVID-19 vaccination. Three were younger male individuals (age, 23-36 years) and 1 was a 70-year-old female individual. All 4 had received the second dose of an mRNA vaccine (2 received mRNA-1273 [Moderna], and 2 received BNT162b2 [Pfizer]). All presented with severe chest pain, had biomarker evidence of myocardial injury, and were hospitalized. Coincident testing for COVID-19 and respiratory viruses provided no alternative explanation. Cardiac magnetic resonance imaging findings were typical for myocarditis, including regional dysfunction, late gadolinium enhancement, and elevated native T1 and T2. Conclusions and Relevance In this study, magnetic resonance imaging findings were found to be consistent with acute myocarditis in 7 patients; 4 of whom had preceding COVID-19 vaccination. Further investigation is needed to determine associations of COVID-19 vaccination and myocarditis.
Subject(s)

Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccination / COVID-19 Vaccines / COVID-19 / Myocarditis Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Adult / Aged / Female / Humans / Male Language: English Journal: JAMA Cardiol Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccination / COVID-19 Vaccines / COVID-19 / Myocarditis Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid / Vaccines Limits: Adult / Aged / Female / Humans / Male Language: English Journal: JAMA Cardiol Year: 2021 Document Type: Article