Abstract
Messenger RNA (mRNA) coronavirus disease of 2019 (COVID-19) vaccines have been recently associated with acute myocarditis, predominantly in healthy young males. Out of 231,989 vaccines administrated in our region (Marche, Italy), we report a case series of six healthy patients (four males and two females, 16.5 years old (Q1, Q3: 15, 18)) that experienced mRNA-COVID-19-vaccines side effects. All patients were hospitalized due to fever and troponins elevation following the second dose of an mRNA-based COVID-19 vaccine. Cardiovascular magnetic resonance (CMR) was performed 72–96 h after vaccination. All patients were treated with colchicine and ibuprofen. Myocarditis was prevalent in males. It was characterized by myocardial edema and late gadolinium enhancement (LGE) in the lateral wall of the left ventricle (LV). One patient showed sole right ventricular involvement, while the females presented with myopericarditis (myocarditis + pericardial effusion). All patients in our series had preserved LV ejection fraction and remained clinically stable during a relatively short inpatient hospital stay. One case presented with atrial tachycardia. At the follow-up, no significant CMR findings were documented after a three-month medical treatment. According to other recently published case series, our report suggests a possible association between acute myocarditis and myopericarditis with mRNA COVID-19 vaccination in healthy young adults and pediatric patients. Not only males are involved, while some arrhythmic manifestations are possible, such as atrial tachycardia. Conversely, we here highlight the benign nature of such complications and the absence of CMR findings after a three-month medical treatment with colchicine and ibuprofen.
Highlights
Since the coronavirus disease of 2019 (COVID-19) outbreak, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) involved about 169 million people worldwide, 4.0/).resulting in more than 3.5 million deaths [1]
We provide here further details about these observations aiming at specifying their clinical profiles and pre/post-treatment cardiovascular magnetic resonance (CMR) findings
Considering the current number of vaccinations administered in the Marche region, Italy (n = 231,989 www.regione.marche.it/Entra-in-Regione/Vaccini-Covid/Dati-aggior nati accessed on 30 December 2021) [3] and that our hospital is the hub of this region for cardiovascular diseases, we documented and reported a minimal amount of myocarditis/myopericarditis Messenger RNA (mRNA)-COVID-19-vaccination related
Summary
Since the coronavirus disease of 2019 (COVID-19) outbreak, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) involved about 169 million people worldwide, 4.0/).resulting in more than 3.5 million deaths [1]. RNA (mRNA) vaccines (Pfizer-BioNTech and Moderna) to reduce the risk and severity of COVID-19 infection [2]. They were administrated exclusively in the adults. The FDA and EMA extended the mRNA COVID-19 vaccines utilization to ≥12 years old patients, with nearly 1,548,000 doses administrated in the pediatric population only in the United States (US) [3,4]. On 17 May 2021, the US Centers for Disease Control and Prevention (CDC) conveyed various cases of myocarditis within four days after receiving an mRNA-based COVID-19 vaccine, predominantly in younger males after the second vaccine dose [5]. Additional reports followed, suggesting a possible association between acute myocarditis and mRNA-based COVID-19 vaccination in healthy young adults and pediatric patients [6]
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