tetano
Editor, Senior Moderator
BMJ Open
. 2023 Jun 20;13(6):e065687.
doi: 10.1136/bmjopen-2022-065687. Risk of myocarditis and pericarditis in mRNA COVID-19-vaccinated and unvaccinated populations: a systematic review and meta-analysis
Abdallah Alami[SUP] 1 [/SUP], Daniel Krewski[SUP] 2 3 [/SUP], Nawal Farhat[SUP] 4 [/SUP], Donald Mattison[SUP] 2 3 5 [/SUP], Kumanan Wilson[SUP] 6 7 [/SUP], Christopher A Gravel[SUP] 2 8 9 [/SUP], Patrick J Farrell[SUP] 4 [/SUP], James A G Crispo[SUP] 10 11 [/SUP], Nisrine Haddad[SUP] 2 [/SUP], Santiago Perez-Lloret[SUP] 12 13 14 [/SUP], Paul J Villeneuve[SUP] 15 [/SUP]
Affiliations
Objective: To summarise the available evidence on the risk of myocarditis and/or pericarditis following mRNA COVID-19 vaccination, compared with the risk among unvaccinated individuals in the absence of COVID-19 infection.
Design: Systematic review and meta-analysis.
Data sources: Electronic databases (Medline, Embase, Web of Science and WHO Global Literature on Coronavirus Disease), preprint repositories (medRxiv and bioRxiv), reference lists and grey literature were searched from 1 December 2020 until 31 October 2022.
Study selection: Epidemiological studies of individuals of any age who received at least one dose of an mRNA COVID-19 vaccine, reported a risk of myo/pericarditis and compared the risk of myo/pericarditis to individuals who did not receive any dose of an mRNA COVID-19 vaccine.
Data extraction and synthesis: Two reviewers independently conducted screening and data extraction. The rate of myo/pericarditis among vaccinated and unvaccinated groups was recorded, and the rate ratios were calculated. Additionally, the total number of individuals, case ascertainment criteria, percentage of males and history of SARS-CoV-2 infection were extracted for each study. Meta-analysis was done using a random-effects model.
Results: Seven studies met the inclusion criteria, of which six were included in the quantitative synthesis. Our meta-analysis indicates that within 30-day follow-up period, vaccinated individuals were twice as likely to develop myo/pericarditis in the absence of SARS-CoV-2 infection compared to unvaccinated individuals, with a rate ratio of 2.05 (95% CI 1.49-2.82).
Conclusion: Although the absolute number of observed myo/pericarditis cases remains quite low, a higher risk was detected in those who received mRNA COVID-19 vaccinations compared with unvaccinated individuals in the absence of SARS-CoV-2 infection. Given the effectiveness of mRNA COVID-19 vaccines in preventing severe illnesses, hospitalisations and deaths, future research should focus on accurately determining the rates of myo/pericarditis linked to mRNA COVID-19 vaccines, understanding the biological mechanisms behind these rare cardiac events and identifying those most at risk.
Keywords: COVID-19; Epidemiology; PUBLIC HEALTH.
. 2023 Jun 20;13(6):e065687.
doi: 10.1136/bmjopen-2022-065687. Risk of myocarditis and pericarditis in mRNA COVID-19-vaccinated and unvaccinated populations: a systematic review and meta-analysis
Abdallah Alami[SUP] 1 [/SUP], Daniel Krewski[SUP] 2 3 [/SUP], Nawal Farhat[SUP] 4 [/SUP], Donald Mattison[SUP] 2 3 5 [/SUP], Kumanan Wilson[SUP] 6 7 [/SUP], Christopher A Gravel[SUP] 2 8 9 [/SUP], Patrick J Farrell[SUP] 4 [/SUP], James A G Crispo[SUP] 10 11 [/SUP], Nisrine Haddad[SUP] 2 [/SUP], Santiago Perez-Lloret[SUP] 12 13 14 [/SUP], Paul J Villeneuve[SUP] 15 [/SUP]
Affiliations
- PMID: 37339840
- DOI: 10.1136/bmjopen-2022-065687
Objective: To summarise the available evidence on the risk of myocarditis and/or pericarditis following mRNA COVID-19 vaccination, compared with the risk among unvaccinated individuals in the absence of COVID-19 infection.
Design: Systematic review and meta-analysis.
Data sources: Electronic databases (Medline, Embase, Web of Science and WHO Global Literature on Coronavirus Disease), preprint repositories (medRxiv and bioRxiv), reference lists and grey literature were searched from 1 December 2020 until 31 October 2022.
Study selection: Epidemiological studies of individuals of any age who received at least one dose of an mRNA COVID-19 vaccine, reported a risk of myo/pericarditis and compared the risk of myo/pericarditis to individuals who did not receive any dose of an mRNA COVID-19 vaccine.
Data extraction and synthesis: Two reviewers independently conducted screening and data extraction. The rate of myo/pericarditis among vaccinated and unvaccinated groups was recorded, and the rate ratios were calculated. Additionally, the total number of individuals, case ascertainment criteria, percentage of males and history of SARS-CoV-2 infection were extracted for each study. Meta-analysis was done using a random-effects model.
Results: Seven studies met the inclusion criteria, of which six were included in the quantitative synthesis. Our meta-analysis indicates that within 30-day follow-up period, vaccinated individuals were twice as likely to develop myo/pericarditis in the absence of SARS-CoV-2 infection compared to unvaccinated individuals, with a rate ratio of 2.05 (95% CI 1.49-2.82).
Conclusion: Although the absolute number of observed myo/pericarditis cases remains quite low, a higher risk was detected in those who received mRNA COVID-19 vaccinations compared with unvaccinated individuals in the absence of SARS-CoV-2 infection. Given the effectiveness of mRNA COVID-19 vaccines in preventing severe illnesses, hospitalisations and deaths, future research should focus on accurately determining the rates of myo/pericarditis linked to mRNA COVID-19 vaccines, understanding the biological mechanisms behind these rare cardiac events and identifying those most at risk.
Keywords: COVID-19; Epidemiology; PUBLIC HEALTH.