SPC365

Myocarditis, Pericarditis and Covid-19 vaccination - a true concern?

Session: Comunicações Orais (Sessão 29) - Doenças do Miocárdio e Pericárdio 2 - Vários Tópicos
Speaker: Tânia Proença

Congress: CPC 2022
Topic: F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme: 17. Myocardial Disease
Subtheme: 17.6 Myocardial Disease – Clinical
Session Type: Comunicações Orais
FP Number: ---
Authors: Tânia Proença; Ricardo Alves Pinto; Miguel Martins Carvalho; Filipa Amador; Catarina Costa; João Calvão; André Cabrita; Catarina Marques; Cátia Priscila; Ana Pinho; Luís Santos; Paula Dias; Filipe Macedo

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#333333">Background</span></span></strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#333333">:&nbsp;Myocarditis and pericarditis are inflammatory diseases affecting 1 to 10 persons in 100&nbsp;000/year. During Covid-19 pandemic, anti-SARS-Cov-2 vaccines are being widely used worldwide, and concerns about its association with a higher risk of cardiac inflammatory syndromes are being raised. National data are warrant to clarify the true prevalence of these possible side effects. </span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"><span style="color:#333333">Purpose:</span></span></strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"> &nbsp;To compare the prevalence and severity of myocarditis and/or pericarditis admissions before and after Covid-19 vaccination. </span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Methods:&nbsp;</span></strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif">We retrospectively analysed all patients admitted to a Cardiology Department due to myocarditis and/or pericarditis during COVID-19 pandemic and compared the clinical data between two 10-months periods, before and after Covid-19 vaccination in Portugal. Pre-vaccination period (PVp) was defined from March to December 2020 and vaccination period (VCp) from January to October 2021.</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Results:</span></strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif"> A total of 23 patients were enrolled, 12 in PVp and 11 in VCp, with a median age of 28 year-old. Of total, 44% had perimyocarditis, 30% myocarditis and 26% pericarditis. In VCp there was significatively more man admitted (50% vs 90%, p=0.019). Concerning clinical data, the two periods were similar; 9% had hypertension, 9% dyslipidemia, 4% were obese, 21% were smokers or previous smokers, and none was diabetic. Only 4% had previous paroxysmal AF and none had CKD. Median CRP was 68 mg/L, and in perimyocarditis or myocarditis median troponin and BNP were 10&nbsp;250 ng/L and 38 pg/mL, respectively. The majority of patients had ECG abnormalities, mostly ST-elevations (39%) and repolarization abnormalities (20%). At presentation, left systolic function was preserved in all patients in PVp group, while 27% had mildly to moderate reduced ejection fraction in VCp (p=0.052); all of them improved to normal function. Of the 17 patients with myocarditis or perimyocarditis, 14 were submitted to MRI (median 6 days after the event): 60% had high signal intensity in T2 weighted sequences suggestive of oedema and 73% had LGE enhancement compatible with myocarditis. Median left and right ventricular ejection fraction by MRI were both 61%. In PVp group, 55% of patients were previous vaccinated (3 patients with Moderna, 1 with Pfizer and 2 with Janssen vaccines). The median time between last vaccine administration and event was 73 days (2-112). In this group, five patients with myocarditis diagnosis previous vaccinated three had no-LGE enhancement while all of non-vaccinated exhibited LGE-enhancement (p=0.038).</span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:&quot;Calibri&quot;,sans-serif"><strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif">Conclusion:</span></strong><span style="font-family:&quot;Calibri Light&quot;,sans-serif">&nbsp;In a Cardiology Department, during two equal periods of 10-months before and </span><span style="font-family:&quot;Calibri Light&quot;,sans-serif">after Covid-19 vaccination in Portugal</span><span style="font-family:&quot;Calibri Light&quot;,sans-serif">, there was no difference in the number of patients admitted with myocarditis and/or pericarditis. Most had a favorable outcome with preserved systolic function. Curiously patient with previous Covid-19 vaccination exhibited less LGE-enhancement on MRI.</span></span></span></p>