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Myocarditis associated with SARS-CoV-2 infection or COVID-19 vaccination: A very rare adverse event?
Session:
Posters (Sessão 2 - Écran 5) - Doenças do miocárdio
Speaker:
Rita Almeida Carvalho
Congress:
CPC 2023
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
17. Myocardial Disease
Subtheme:
17.7 Myocardial Disease - Other
Session Type:
Pósters Electrónicos
FP Number:
---
Authors:
Rita Almeida Carvalho; Miguel S. Domingues; António Tralhão; António Ferreira; Marisa Trabulo; Jorge Ferreira; Miguel Mendes
Abstract
<p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">[Background]: There have been numerous reports of suspected cases of myocarditis following SARS-CoV-2 infection and coronavirus disease 2019 (COVID-19) vaccination. Case series studies from several countries suggest that the risk for both conditions is rare and higher in the 1-28 days after infection or vaccination, particularly in young males who received a booster dose of mRNA vaccines (BNT162b2 and mRNA-1273). </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">[Aim]: The aim of this study was to assess the incidence, clinical course and temporal association with SARS-CoV-2 infection and COVID-19 vaccination after the beginning of the COVID-19 pandemic (COVID), in comparison with a similar time period before the pandemic (Pre-COVID). </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">[Methods]: Retrospective single-center study of patients admitted to the hospital for myocarditis between September 2017 and September 2022. Myocarditis diagnosis was established according to the 2013 European Society of Cardiology (ESC) position statement for clinically suspected myocarditis. Patients with myocarditis diagnosed since March 2020 were considered the COVID group. Outcomes were assessed as a composite of death, acute heart failure, sustained ventricular arrythmia (VA) or <em>de novo</em> left ventricular ejection fraction (LVEF) <50%. </span></span></p> <p><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif">[Results]: A total of 67 patients were included (mean age 40 ± 19 years; 76% males). Overall, 36 (54%) patients were included in the Pre-COVID and 31 (46%) patients in the COVID group. The incidence was 14.4 persons/year and 12.4 persons/year in the Pre- and COVID group, respectively. Clinical features and outcomes did not differ between groups (Table). Overall, in the COVID group, three (10%) patients presented with myocarditis 1-28 days after vaccination, all of which had received a BNT162b2 vaccine booster dose. In the same group, two (6%) patients had myocarditis 1-28 days after infection, both with acute heart failure and LVEF <50% during hospitalization. </span></span></p> <p><span style="font-size:11.0pt"><span style="font-family:"Calibri",sans-serif">[Conclusion]: In our small series, the incidence and clinical course of myocarditis did not differ during a similar time span period before and after the beginning of the COVID-19 pandemic. In the COVID group, 16% of myocarditis cases were temporally associated with either SARS-CoV-2 infection or COVID-19 vaccination, particularly after a booster dose of mRNA vaccines. Patients with myocarditis 1-28 days after SARS-CoV-2 infection experienced worse outcomes.</span></span></p>
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