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COVID-19 vaccination and carditis in children and adolescents: a systematic review and meta-analysis.
Chou, Oscar Hou In; Mui, Jonathan; Chung, Cheuk To; Radford, Danny; Ranjithkumar, Simon; Evbayekha, Endurance; Nam, Ronald; Pay, Levent; Satti, Danish Iltaf; Garcia-Zamora, Sebastian; Bazoukis, George; Çinier, Göksel; Lee, Sharen; Vassiliou, Vassilios S; Liu, Tong; Tse, Gary; Wong, Ian Chi Kei; Chou, Oscar Hou In; Liu, Tong; Tse, Gary.
  • Chou OHI; Epidemiology Research Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China.
  • Mui J; Epidemiology Research Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China.
  • Chung CT; Epidemiology Research Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China.
  • Radford D; Epidemiology Research Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China.
  • Ranjithkumar S; Kent and Medway Medical School, Canterbury Christ Church University, Canterbury, UK.
  • Evbayekha E; Kent and Medway Medical School, University of Kent, Canterbury, United Kingdom.
  • Nam R; Faculty of Health and Life Sciences, Aston University Medical School, Birmingham, B4 7ET, UK.
  • Pay L; Epidemiology Research Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China.
  • Satti DI; Epidemiology Research Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China.
  • Garcia-Zamora S; Faculty of Health and Life Sciences, Aston University Medical School, Birmingham, B4 7ET, UK.
  • Bazoukis G; Department of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, 34668, Istanbul, Turkey.
  • Çinier G; Epidemiology Research Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China.
  • Lee S; Cardiac Intensive Care Unit, Department of Cardiology, Delta Clinic, Rosario, Santa Fe, Argentina.
  • Vassiliou VS; Department of Cardiology, Medical School, University of Nicosia, 2408, Nicosia, Cyprus.
  • Liu T; Department of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, 34668, Istanbul, Turkey.
  • Tse G; Epidemiology Research Unit, Cardiovascular Analytics Group, China-UK Collaboration, Hong Kong, China.
  • Wong ICK; Department of Medicine, Bob Champion Research and Education, Norwich Medical School, University of East Anglia and Norfolk and Norwich University Hospital, Rosalind Franklin Rd, Norwich, NR4 7UQ, UK. v.vassiliou@uea.ac.uk.
  • Chou OHI; Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China. gary.tse@kmms.ac.uk.
  • Liu T; Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK. gary.tse@kmms.ac.uk.
  • Tse G; Kent and Medway Medical School, University of Kent, Canterbury, United Kingdom. gary.tse@kmms.ac.uk.
Clin Res Cardiol ; 111(10): 1161-1173, 2022 Oct.
Article in English | MEDLINE | ID: covidwho-1971699
ABSTRACT

BACKGROUND:

Coronavirus Disease-2019 (COVID-19) vaccination has been associated with the development of carditis, especially in children and adolescent males. However, the rates of these events in the global setting have not been explored in a systematic manner. The aim of this systematic review and meta-analysis is to investigate the rates of carditis in children and adolescents receiving COVID-19 vaccines.

METHODS:

PubMed, Embase and several Latin American databases were searched for studies. The number of events, and where available, at-risk populations were extracted. Rate ratios were calculated and expressed as a rate per million doses received. Subgroup analysis based on the dose administered was performed. Subjects ≤ 19 years old who developed pericarditis or myocarditis following COVID-19 vaccination were included.

RESULTS:

A total of 369 entries were retrieved. After screening, 39 articles were included. Our meta-analysis found that 343 patients developed carditis after the administration of 12,602,625 COVID-19 vaccination doses (pooled rate per million 37.76; 95% confidence interval [CI] 23.57, 59.19). The rate of carditis was higher amongst male patients (pooled rate ratio 5.04; 95% CI 1.40, 18.19) and after the second vaccination dose (pooled rate ratio 5.60; 95% CI 1.97, 15.89). In 301 cases of carditis (281 male; mean age 15.90 (standard deviation [SD] 1.52) years old) reported amongst the case series/reports, 261 patients were reported to have received treatment. 97.34% of the patients presented with chest pain. The common findings include ST elevation and T wave abnormalities on electrocardiography. Oedema and late gadolinium enhancement in the myocardium were frequently observed in cardiac magnetic resonance imaging (CMR). The mean length of hospital stay was 3.91 days (SD 1.75). In 298 out of 299 patients (99.67%) the carditis resolved with or without treatment.

CONCLUSIONS:

Carditis is a rare complication after COVID-19 vaccination across the globe, but the vast majority of episodes are self-limiting with rapid resolution of symptoms within days. Central illustration. Balancing the benefits of vaccines on COVID-19-caused carditis and post-vaccination carditis.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccines / COVID-19 Vaccines / COVID-19 / Myocarditis Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Topics: Long Covid / Vaccines Limits: Adolescent / Adult / Child / Humans / Infant / Male / Young adult Language: English Journal: Clin Res Cardiol Journal subject: Cardiology Year: 2022 Document Type: Article Affiliation country: S00392-022-02070-7

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Vaccines / COVID-19 Vaccines / COVID-19 / Myocarditis Type of study: Observational study / Prognostic study / Reviews / Systematic review/Meta Analysis Topics: Long Covid / Vaccines Limits: Adolescent / Adult / Child / Humans / Infant / Male / Young adult Language: English Journal: Clin Res Cardiol Journal subject: Cardiology Year: 2022 Document Type: Article Affiliation country: S00392-022-02070-7