The Incidence of Myocarditis and Pericarditis in Post COVID-19 Unvaccinated Patients-A Large Population-Based Study
https://pubmed.ncbi.nlm.nih.gov/35456309/
The authors declare no conflict of interest.
Myocarditis and pericarditis are potential post-acute cardiac sequelae of COVID-19 infection,
arising from adaptive immune responses.
We aimed to study the incidence of post-acute COVID-19 myocarditis and pericarditis.
Retrospective cohort study
N = 196,992 adults after COVID-19 infection
Clalit Health Services members in Israel
March 2020 and January 2021
The control cohort (no infection)
N = 590,976 adults
Age- and sex-matched
COVID infection cohort
Nine post-COVID-19 patients developed myocarditis (0.0046%)
Eleven patients were diagnosed with pericarditis (0.0056%).
Non- COVID infection cohort
27 patients had myocarditis (0.0046%)
52 had pericarditis (0.0088%)
Age adjusted hazard ratio
0.96
95% confidence interval, 0.93 to 1.00
Male sex, aHR 4.42; were associated with myocarditis
Male sex aHR 1.93; were associated with pericarditis
Post COVID-19 infection was not associated with either myocarditis or pericarditis
aHR 1.08; for myocarditis
aHR 0.53; for myocarditis
We did not observe an increased incidence of neither pericarditis nor myocarditis in adult patients recovering from COVID-19 infection.
Myocarditis and pericarditis (21st March 2022)
https://www.gov.uk/government/publications/covid-19-vaccination-myocarditis-and-pericarditis-information-for-healthcare-professionals/information-for-healthcare-professionals-on-myocarditis-and-pericarditis-following-covid-19-vaccination
In 2017
https://www.ahajournals.org/doi/10.1161/circ.140.suppl_1.11463
About 2,000 hospital admissions for myocarditis
Two-thirds of cases were in men
Median age for men, 33
Mostly viral
https://www.mdpi.com/2077-0383/10/4/603
Presentation of acute myocarditis
Subclinical disease too,
heart failure, chest pain, shortness of breath, palpitations and fatigue.
Dilated cardiomyopathy and chronic heart failure
Sudden death syndrome
https://www.sciencedirect.com/science/article/abs/pii/S0033062009000966?via%3Dihub
Myocarditis implicated in 12% of sudden deaths under the age of 40
Acute pericarditis
Often similar presentation
Some concurrent myocardial involvement (myopericarditis)
Constrictive pericarditis is uncommon
https://heart.bmj.com/content/101/14/1159
Can myocarditis or pericarditis be caused by coronavirus (COVID-19) infection?
It is now recognised that COVID-19 infection can lead to myocarditis or pericarditis
https://pubmed.ncbi.nlm.nih.gov/34516657/
Professional athletes are an atypical group
Published online 2021 May 27
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8160916/
1,597 athletes with recent SARS-CoV-2 infection
(March 1, 2020, through December 15, 2020)
0.31% were diagnosed with myocarditis using a symptom-based screening
2.3% were diagnosed with clinical or subclinical myocarditis using cardiac magnetic resonance screening
Is there an association of myocarditis or pericarditis following COVID-19 vaccination?
Many studies have now shown that there is an increased risk of myocarditis following vaccination with an mRNA vaccine,
https://www.nejm.org/doi/full/10.1056/NEJMoa2110737
https://www.cdc.gov/mmwr/volumes/70/wr/mm7027e2.htm
https://www.nejm.org/doi/full/10.1056/NEJMoa2109730
https://www.gov.uk/government/publications/myocarditis-and-pericarditis-after-covid-19-vaccination
especially in young men under the age of 40.
Many of the studies have only limited follow up ……
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