CV. COVID-19 Vaccination-Associated Myocarditis in Adolescents

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Jain SS, Steele JM, Fonseca B, et al. COVID-19 vaccination-associated myocarditis in adolescents. Pediatrics. 2021; doi: 10.1542/peds.2021-053427

Recopilado por Carlos Cabrera Lozada. Director del postgrado de Medicina Materno Fetal. Universidad Central de Venezuela. ORCID: 0000-0002-3133-5183. 22/08/2021

Abstract

Objective: This study aimed to characterize the clinical presentation, short-term prognosis, and myocardial tissue changes associated with acute myocarditis following COVID-19 vaccination in the pediatric population. Methods: In this retrospective multicenter study across 16 US hospitals, patients <21 years of age with a diagnosis of myocarditis following COVID-19 vaccination were included and compared to a cohort with the multisystem inflammatory syndrome in children (MIS-C). Younger children with vaccine-associated myocarditis were compared to older adolescents. Results: 63 patients with a mean age of 15.6 years were included. 92% were male. All had received an mRNA vaccine and, except for one, presented following the 2nd dose. Four patients had significant dysrhythmia. 14% had mild left ventricular dysfunction on echocardiography which resolved on discharge. 88% met the diagnostic cardiac magnetic resonance (CMR) Lake Louise criteria for myocarditis. Myocardial injury was more prevalent in comparison to MIS-C patients. None of the patients required inotropic, mechanical, or circulatory support. There were no deaths. Follow-up data obtained in 86% of patients, at a mean of 35 days showed resolution of symptoms, arrhythmias, and ventricular dysfunction. Conclusions: Clinical characteristics and early outcomes are similar between the different pediatric age groups. There is evidence of myocardial inflammation and injury following mRNA COVID-19 vaccination as seen on CMR. The hospital course is mild with quick clinical recovery and excellent short-term outcomes. Close follow-up and further studies are needed to understand the long-term implications and mechanism of these myocardial tissue changes.

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