P367 LONG–TERM BENIGN EVOLUTION OF SARS–COV 2 VACCINE RELATE MYOPERICARDITIS

Abstract

Abstract Background Myopericarditis following vaccination for Sars–CoV2 disease (COVID–19) is a described entity, but its long–term evolution is not yet clear. Methods Patients diagnosed with myopericarditis after COVID–19 mRNA vaccine represented our population. Clinical evaluation, laboratory tests, noninvasive tests, echocardiography, and cardiac magnetic resonance (CMR) were performed at baseline, six months, and twelve months. Results Between January and August 2021, we identified 7 patients with myopericarditis after vaccination with Sars–CoV 2 mRNA. The mean age of the patients was 29 years (IQR: 25.5–53.5 years). and all patients were male. The median time from vaccine administration to symptom onset was 5 days (IQR: 4–7 days); five patients received BNT162b2, two mRNA–1273, and only one patient developed symptoms after the first vaccine dose. The most common symptoms at presentation were chest pain (100%) and fatigue (71.4%). Left ventricular ejection fraction (LVEF) remained preserved in 6 of them while it was found to be slightly reduced in one (median LVEF: 61.3% [IQR: 60–62.9%]). Late Gadolinium enhancement (LGE) was detected by CMR in 42.9% of cases. Treatment was conservative for all patients except one in whom pericardiocentesis was required due to massive pericardial effusion. At the 6–month follow–up all patients were asymptomatic with normal troponin levels, electrocardiographic and echocardiographic parameters and CMR, data which confirmed the complete resolution of the inflammatory state. At the twelve–month follow–up, the CMR confirmed the resolution of the inflammatory picture. Two patients received the booster dose of COVID–19 vaccine without evidence of myopericardial involvement. Conclusions COVID19 mRNA vaccination–associated myopericarditis is more frequent in young males and is usually characterized by a benign evolution.