Are Covid-19 vaccines affecting the heart?

Answer from top 10 papers

COVID-19 vaccines have been associated with cardiovascular side effects, although these events are relatively rare. The literature indicates that while the vaccines are generally safe and effective, there have been reports of myocarditis, particularly with mRNA-based vaccines, and other thromboembolic events (Lin, 2023; Shiravi et al., 2021). These cardiovascular complications can be serious but are considered uncommon when compared to the benefits of vaccination in controlling the pandemic and reducing mortality rates (Shiravi et al., 2021).
Interestingly, while cardiovascular side effects have been observed, the incidence is low, and the specific mechanisms underlying these reactions are still under investigation. The mRNA vaccines, such as those developed by Pfizer/BioNTech and Moderna, have been linked to myocarditis and pericarditis, especially in younger adults following the second dose (Shiravi et al., 2021). Other types of vaccines have been associated with different cardiovascular complications, such as thromboembolic events (Lin, 2023).
In summary, while there is evidence of cardiovascular effects related to COVID-19 vaccines, these are relatively rare and the benefits of vaccination in preventing COVID-19 and its severe outcomes outweigh the risks of these side effects. Continued monitoring and research are essential to further understand and mitigate these risks (Lin, 2023; Shiravi et al., 2021).

Source Papers

Cardiovascular disease in SARS-CoV-2 infection.

Pre‐existing cardiovascular disease (CVD) increases the morbidity and mortality of COVID‐19 and is strongly associated with poor disease outcomes. However, SARS‐CoV‐2 infection can also trigger de novo acute and chronic cardiovascular disease. Acute cardiac complications include arrhythmia, myocarditis and heart failure, which are significantly associated with higher in‐hospital mortality. The possible mechanisms by which SARS‐CoV‐2 causes this acute cardiac disease include direct damage caused by viral invasion of cardiomyocytes as well as indirect damage through systemic inflammation. The long‐term cardiac complications associated with COVID‐19 are incompletely characterised and thought to include hypertension, arrhythmia, coronary atherosclerosis and heart failure. Although some cardiac‐related symptoms can last over 6 months, the effect of these complications on long‐term patient health remains unclear. The risk factors associated with long‐term cardiovascular disease remain poorly defined. Determining which patients are most at‐risk of long‐term cardiovascular disease is vital so that targeted follow‐up and patient care can be provided. The aim of this review was to summarise the current evidence of the acute and long‐term cardiovascular consequences of SARS‐CoV‐2 infection and the mechanisms by which SARS‐CoV‐2 may cause cardiovascular disease.

Open Access
Cardiovascular Complications of SARS-CoV-2 Vaccines: An Overview.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of the deadly disease known as coronavirus disease 2019 (COVID-19) that has reached pandemic proportions. Currently, there is no definitive treatment for COVID-19, although many vaccines have been developed. The World Health Organization has approved the safety and efficacy of the AstraZeneca/Oxford, Johnson and Johnson/Janssen (JnJ), Moderna, Pfizer/BioNTech, Sinopharm, and Sinovac vaccines so far. The approved formulations of AstraZeneca, JnJ, and Gam-COVID-vac (Sputnik V) contain DNA delivered within non-replicating recombinant adenovirus vector-based systems, while the Pfizer and Moderna vaccines utilize mRNA technology and lipid nanoparticle delivery systems. All of these vaccines encode production of the SARS-CoV-2 spike (S) protein, ultimately triggering immunity in the human body. COVID-19 causes several cardiovascular complications, such as arrhythmias, myocarditis, pericarditis, and venous thromboembolism. SARS-CoV-2 vaccines have been associated with rare, but sometimes fatal, cardiovascular side effects, which are the topics of this review. SARS-CoV-2 vaccines in general may cause thromboembolic events, such as cerebral vein thrombosis, and mRNA-based vaccines in particular may cause myocarditis/pericarditis, with the latter more likely to occur in younger adults after the second vaccination dose. Nevertheless, the advantages of these vaccines for ending the pandemic and/or decreasing the mortality rate outweigh any risk for the rare cardiovascular complications.

Open Access
Review: SARS-CoV-2, Cardiovascular Disease, Pathophysiology and Role of ACE2 in Cardiac Injury

The coronavirus disease-2019 (COVID-19), an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has hit the world very hard by affecting millions of people across countries hence posing a major health threat on a global scale. This novel virus is thought to enter and cause infection in its host through the attachment of its structural protein known as the S-glycoprotein to angiotensin-converting enzyme 2 (ACE2). COVID-19 is presented with asymptomatic, mild, or severe pneumonia-like symptoms. During the infection, the cardiovascular system is affected by unknown pathophysiological processes. Among COVID-19 patients, cardiovascular disease (CVD) is resulting into cardiac injury, acute coronary syndrome (ACS), myocardial infarction (MI), arrhythmic infestation and myocarditis. The results of the meta-analysis suggest that CVD and its risk factors are closely related to fatal outcomes in COVID-19 for patients across all ages. Hence, from a cardiovascular standpoint, there are concerns as to whether patients with underlying cardiovascular conditions are at a higher risk of an aggravated COVID-19 infection. Also, as to whether COVID-19 infections induce cardiomyopathies that were not in existence prior to the infection. Nonetheless, much needs to be discovered about the cardiac involvement of this novel coronavirus (nCoV) infection and its relationship with cardiovascular diseases (CVDs). For acute CVD events, the use of antiplatelet agents, β-blockers, angiotensin-converting enzyme inhibitors (ACEIs), angiotensin-receptor blockers (ARBs) and statins are recommended per practice guidelines. Whether the medications which patients used for cardiovascular disease will interfere with the treatment or the outcome of COVID-19, is still unknown. With the invent of vaccines and as new clinical evidences emerging, the diagnosis and treatment may change. The purpose of this concise review is to discuss CVD and related potential disorders in patients with COVID-19 which involves SARS-CoV-2 infection, pathophysiology, role of ACE2 in cardiac injury, possible mechanism of cardiac complications and clinical manifestations.

Open Access