Sličnosti i razlike kardiovaskularnih komplikacija COVID-19 infekcije i COVID-19 vakcinacije

Abstract

COVID-19 patients may experience with a wide range of cardiovascular complications during infection: obstructive and non-obstructive coronary artery disease-acute coronary syndrome (myocardial infarction type 1 and type 2), arterial or venous thromboembolic diseases, myocarditis, pericarditis, pericardial effusion, stress cardiomyopathy (Takotsubo syndrome), arrhythmias, acute heart failure, shock and sudden cardiac death (cardiac arrest). Cardiovascular complications that may occur after COVID-19 vaccination are: myocarditis, pericarditis, thromboembolic events, hypertension, acute coronary syndrome, stress cardiomyopathy, arrhythmias and cardiac arrest. Myocarditis and pericarditis occurred in 3/4 of all cases after the second dose of mRNA vaccine against SARS-COV2 virus, most often in young adults. Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare condition that occurs after vaccination against SARS-COV2, more prevalently in young women (under 50 years of age). The incidence of acute myocardial infarction is 0.02% and 0.03% depending on the type of mRNA vaccine (Pfizer or Moderna), more common in males and the elderly, with symptoms onset the most frequently up to 24 hours after vaccine application. The most common arrhythmias that occur after COVID-19 vaccination are sinus tachycardia, atrial fibrillation, and supraventricular tachycardia. The benefit-risk ratio of COVID-19 vaccination to the occurrence of cardiovascular complications strongly prevails in favor of vaccines for all age groups (older than 12 years) and for both sexes.