tetano
Editor, Senior Moderator
Curr Cardiol Rep
. 2024 Feb 7.
doi: 10.1007/s11886-024-02021-w. Online ahead of print. Fulminant Myocarditis Temporally Associated with COVID-19 Vaccination
Enrico Ammirati[SUP] 1 2 [/SUP], Nicolina Conti[SUP] 3 [/SUP], Matteo Palazzini[SUP] 3 [/SUP], Matteo Rocchetti[SUP] 4 [/SUP], Andrea Spangaro[SUP] 4 [/SUP], Andrea Garascia[SUP] 3 [/SUP], Laura Lupi[SUP] 5 [/SUP], Alberto Cereda[SUP] 4 [/SUP]
Affiliations
Purpose of review: Coronavirus disease-2019 (COVID-19) vaccines have been related to rare cases of acute myocarditis, occurring between 1 in 10,000 and 1 in 100,000 individuals, approximately. Incidence of COVID-19 vaccine-associated myocarditis varies with age, sex, and type of vaccine. Although most patients with acute myocarditis temporally associated with COVID-19 vaccines have an uneventful course, a small subpopulation presents with cardiogenic shock (termed fulminant myocarditis [FM]). This review explored the prevalence, clinical presentation, management, and prognosis of COVID-19 vaccine-associated acute myocarditis, specifically focusing on FM and comparing patients with fulminant versus non-fulminant myocarditis.
Recent findings: Cases of FM represent about 2-4% (0 to 7.5%) of COVID-19 vaccine-associated acute myocarditis cases, and mortality is around 1%, ranging between 0 and 4.4%. First, we identified 40 cases of FM up to February 2023 with sufficient granular data from case reports and case series of COVID-19 vaccine-associated acute myocarditis that occurred within 30 days from the last vaccine injection. This population was compared with 294 cases of non-fulminant acute myocarditis identified in the literature during a similar time. Patients with FM were older (48 vs. 27 years), had a larger proportion of women (58% vs. 9%), and mainly occurred after the first shot compared with non-fulminant cases (58% vs. 16%). The reported mortality was 27% (11 out of 40), in line with non-vaccine-associated fulminant myocarditis. These data were in agreement with 36 cases of FM from a large Korean registry. Herein, we reviewed the clinical features, imaging results, and histological findings of COVID-19 vaccine-associated fulminant myocarditis. In conclusion, COVID-19 vaccine-associated FM differs from non-fulminant forms, suggesting potential specific mechanisms in these rare and severe forms. Mortality in vaccine-associated FM remains high, in line with other forms of FM.
Keywords: COVID-19 vaccine; Fulminant myocarditis; Histology; Myocarditis; Outcome.
. 2024 Feb 7.
doi: 10.1007/s11886-024-02021-w. Online ahead of print. Fulminant Myocarditis Temporally Associated with COVID-19 Vaccination
Enrico Ammirati[SUP] 1 2 [/SUP], Nicolina Conti[SUP] 3 [/SUP], Matteo Palazzini[SUP] 3 [/SUP], Matteo Rocchetti[SUP] 4 [/SUP], Andrea Spangaro[SUP] 4 [/SUP], Andrea Garascia[SUP] 3 [/SUP], Laura Lupi[SUP] 5 [/SUP], Alberto Cereda[SUP] 4 [/SUP]
Affiliations
- PMID: 38324216
- DOI: 10.1007/s11886-024-02021-w
Purpose of review: Coronavirus disease-2019 (COVID-19) vaccines have been related to rare cases of acute myocarditis, occurring between 1 in 10,000 and 1 in 100,000 individuals, approximately. Incidence of COVID-19 vaccine-associated myocarditis varies with age, sex, and type of vaccine. Although most patients with acute myocarditis temporally associated with COVID-19 vaccines have an uneventful course, a small subpopulation presents with cardiogenic shock (termed fulminant myocarditis [FM]). This review explored the prevalence, clinical presentation, management, and prognosis of COVID-19 vaccine-associated acute myocarditis, specifically focusing on FM and comparing patients with fulminant versus non-fulminant myocarditis.
Recent findings: Cases of FM represent about 2-4% (0 to 7.5%) of COVID-19 vaccine-associated acute myocarditis cases, and mortality is around 1%, ranging between 0 and 4.4%. First, we identified 40 cases of FM up to February 2023 with sufficient granular data from case reports and case series of COVID-19 vaccine-associated acute myocarditis that occurred within 30 days from the last vaccine injection. This population was compared with 294 cases of non-fulminant acute myocarditis identified in the literature during a similar time. Patients with FM were older (48 vs. 27 years), had a larger proportion of women (58% vs. 9%), and mainly occurred after the first shot compared with non-fulminant cases (58% vs. 16%). The reported mortality was 27% (11 out of 40), in line with non-vaccine-associated fulminant myocarditis. These data were in agreement with 36 cases of FM from a large Korean registry. Herein, we reviewed the clinical features, imaging results, and histological findings of COVID-19 vaccine-associated fulminant myocarditis. In conclusion, COVID-19 vaccine-associated FM differs from non-fulminant forms, suggesting potential specific mechanisms in these rare and severe forms. Mortality in vaccine-associated FM remains high, in line with other forms of FM.
Keywords: COVID-19 vaccine; Fulminant myocarditis; Histology; Myocarditis; Outcome.
