背景:心肌炎被越来越多地报道为Pfizer-BioNTech和ModernaCOVID-19疫苗的潜在并发症。根据CDC(疾病控制中心)疫苗不良事件报告系统,截至2021年9月2日,报告了一千五百二十二个病例。大多数公布的数据以病例报告和系列的形式提供。有必要编制人口统计数据,临床特征,以及这些患者的结果。方法:在PubMed进行了系统的检索,Embase,WebofScience,和谷歌学者在2020年1月1日至2021年7月17日期间发表的文献。从25份合格病例报告和病例系列中汇集了69例患者的个人数据。
结果:发病年龄中位数为21岁。92.7%的患者为男性。76.8%的患者接受了辉瑞-BioNTech疫苗,23.2%的人接受了Moderna疫苗。88.5%在第二剂量后出现症状。患者在接种疫苗后平均三天入院。所有患者均有胸痛和肌钙蛋白升高。87%的患者在心脏MRI上证实了心肌炎。大多数患者在MRI上有晚期钆增强。平均住院时间为4天。所有报告患者均康复出院。
结论:mRNA疫苗接种后心肌炎主要见于年轻男性第二次疫苗接种后几天。心肌炎的病理生理学尚不清楚。预后良好,所有报告的患者均已康复。心脏MRI上钆晚期增强的存在表明心肌坏死/纤维化,需要进一步研究以确定该疾病的长期预后。
BACKGROUND: Myocarditis is being increasingly reported as a potential complication of both Pfizer-BioNTech and Moderna vaccines for COVID-19. One thousand five hundred and twenty-two cases were reported as of September 02, 2021, as per CDC\'s (Centers for Disease Control) vaccine adverse event reporting system. Most of the published data is available in the form of case reports and series. There is a need to compile the demographic data, clinical features, and outcomes in these patients. Methods: A systematic search was conducted in PubMed, Embase, Web of science, and google scholar for published literature between January 01, 2020, and July 17, 2021. Individual data of 69 patients were pooled from 25 qualifying case reports and case series.
RESULTS: The median age of onset was 21 years. 92.7% of the patients were male. 76.8% of patients received the Pfizer-BioNTech vaccine, and 23.2% received the Moderna vaccine. 88.5% developed symptoms after the second dose. Patients were admitted to the hospital a median of three days post-vaccination. All the patients had chest pain and elevated troponin. The myocarditis was confirmed on cardiac MRI in 87% of the patients. Most of the patients had late gadolinium enhancement on MRI. The median length of stay was four days. All the reported patients recovered and were discharged.
CONCLUSIONS: Post-mRNA vaccination myocarditis is seen predominantly in young males within a few days after their second dose of vaccination. The pathophysiology of myocarditis is not well known. The prognosis is good as all the reported patients recovered. The presence of late gadolinium enhancement on cardiac MRI indicated myocardial necrosis/fibrosis and further studies are needed to establish the long-term prognosis of the condition.