Myocarditis After BNT162b2 and mRNA-1273 Vaccination
2021; Lippincott Williams & Wilkins; Volume: 144; Issue: 6 Linguagem: Inglês
10.1161/circulationaha.121.055913
ISSN1524-4539
AutoresKathryn F. Larson, Enrico Ammirati, Eric Adler, Leslie T. Cooper, Kimberly N. Hong, Gianluigi Saponara, Daniel Couri, Alberto Cereda, Antonio Procopio, Cristina Cavalotti, Fabrizio Oliva, Tommaso Sanna, Vincenzo Antonio Ciconte, George Onyango, David R. Holmes, Daniel D. Borgeson,
Tópico(s)Animal Virus Infections Studies
ResumoHomeCirculationVol. 144, No. 6Myocarditis After BNT162b2 and mRNA-1273 Vaccination Free AccessLetterPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissionsDownload Articles + Supplements ShareShare onFacebookTwitterLinked InMendeleyRedditDiggEmail Jump toSupplementary MaterialsFree AccessLetterPDF/EPUBMyocarditis After BNT162b2 and mRNA-1273 Vaccination Kathryn F. Larson, MD, Enrico Ammirati, MD, PhD, Eric D. Adler, MD, Leslie T. Cooper Jr, MD, Kimberly N. Hong, MD, Gianluigi Saponara, MD, Daniel Couri, MD, Alberto Cereda, MD, Antonio Procopio, MD, Cristina Cavalotti, MD, Fabrizio Oliva, MD, Tommaso Sanna, MD, Vincenzo Antonio Ciconte, MD, George Onyango, PA-C, David R. Holmes, MD and Daniel D. Borgeson, MD Kathryn F. LarsonKathryn F. Larson Correspondence to: Kathryn F. Larson, MD, Department of Cardiovascular Medicine, 200 1st St SW, Mayo Clinic, Rochester, MN 55905; Email E-mail Address: [email protected] https://orcid.org/0000-0003-2565-3318 Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (K.F.L., G.O., D.R.H., D.D.B.). *K.F. Larson and E. Ammirati are joint first authors. Search for more papers by this author , Enrico AmmiratiEnrico Ammirati Enrico Ammirati, MD, PhD, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20162, Milano, Italy. Email E-mail Address: [email protected] https://orcid.org/0000-0002-1676-5257 De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy (E.A., C.C., F.O.). *K.F. Larson and E. Ammirati are joint first authors. Search for more papers by this author , Eric D. AdlerEric D. Adler Department of Cardiology, University of California–San Diego (E.D.A., K.N.H.). Search for more papers by this author , Leslie T. Cooper JrLeslie T. Cooper Jr https://orcid.org/0000-0003-1002-3313 Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL (L.T.C.). Search for more papers by this author , Kimberly N. HongKimberly N. Hong Department of Cardiology, University of California–San Diego (E.D.A., K.N.H.). Search for more papers by this author , Gianluigi SaponaraGianluigi Saponara Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Roma, Italy (G.S., T.S.). Search for more papers by this author , Daniel CouriDaniel Couri https://orcid.org/0000-0002-0142-5057 United Heart and Vascular Center, St Paul, MN (D.C.). Search for more papers by this author , Alberto CeredaAlberto Cereda Cardiovascular Department, Association Socio Sanitary Territorial Santi Paolo e Carlo, Milano, Italy (A.C.). Search for more papers by this author , Antonio ProcopioAntonio Procopio Institute of Cardiology and Center of Excellence on Aging, G. d’Annunzio University, Chieti, Italy (A.P.). Search for more papers by this author , Cristina CavalottiCristina Cavalotti De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy (E.A., C.C., F.O.). Search for more papers by this author , Fabrizio OlivaFabrizio Oliva De Gasperis Cardio Center, Niguarda Hospital, Milano, Italy (E.A., C.C., F.O.). Search for more papers by this author , Tommaso SannaTommaso Sanna Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico, Roma, Italy (G.S., T.S.). Search for more papers by this author , Vincenzo Antonio CiconteVincenzo Antonio Ciconte Department of Cardiology, Pugliese-Ciaccio Hospital, Catanzaro, Italy (V.A.C.). Search for more papers by this author , George OnyangoGeorge Onyango Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (K.F.L., G.O., D.R.H., D.D.B.). Search for more papers by this author , David R. HolmesDavid R. Holmes Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (K.F.L., G.O., D.R.H., D.D.B.). Search for more papers by this author and Daniel D. BorgesonDaniel D. Borgeson Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN (K.F.L., G.O., D.R.H., D.D.B.). Search for more papers by this author Originally published16 Jun 2021https://doi.org/10.1161/CIRCULATIONAHA.121.055913Circulation. 2021;144:506–508Other version(s) of this articleYou are viewing the most recent version of this article. Previous versions: June 16, 2021: Ahead of Print The BNT162b2 mRNA (Pfizer-BioNTech) and mRNA-1273 (Moderna) coronavirus disease 2019 (COVID-19) vaccines have gained widespread use across the globe to prevent further spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Early studies and surveillance data suggest these vaccines are associated with no significant adverse events other than very rare anaphylaxis.1,2 Surveillance for other reactions continues.Myocarditis and inflammatory myocardial cellular infiltrate have been reported after vaccination, especially after the smallpox vaccine.3 However, myocarditis occurring after the BNT162b2 mRNA and mRNA-1273 vaccines has not been reported in trials.1,2 Here, we describe 8 patients who were hospitalized with chest pain and who were diagnosed with myocarditis by laboratory and cardiac magnetic resonance imaging within 2 to 4 days of receiving either the BNT162b2 or mRNA-1273 vaccine (Table). Patients provided written informed consent, and the collection of clinical cases followed local Institutional Review Board requirements. The data that support the findings of this study are available from the corresponding author on reasonable request. Two of the patients (patients 3 and 4) had previously been infected by SARS-CoV-2 without need for hospitalization. All individuals were otherwise healthy males between the ages of 21 and 56 years. All but 1 patient developed symptoms after their second dose. Systemic symptoms began within 24 hours after vaccine administration in 5 out of 8 patients, with chest pain presenting between 48 and 96 hours later. Chest pain was most commonly described as constant, nonpositional, and nonpleuritic (only patient 7 reported pericardial pain), consistent with acute myocarditis mainly without pericardial involvement. Troponin values were elevated in all individuals and appeared to peak the day after admission, whereas no patient had eosinophilia. All patients were tested and were negative for SARS-CoV-2. Left ventricular ejection fraction was reduced (<50%) in 2 of 8 (25%) patients with a median left ventricular ejection fraction of 51.5% (first to third quartile, 48% to 59%). Five patients demonstrated regional wall motion abnormalities with inferior and inferolateral walls involved, and the remaining 3 cases had generalized hypokinesis. Some patients were tachycardic at presentation, but no patients required inotropes or mechanical circulatory support. All but 3 patients (patients 1, 2, and 5) underwent coronary imaging by computed tomography or catheter-based angiography to rule out coronary artery disease. Cardiac magnetic resonance imaging revealed patchy delayed gadolinium enhancement consistent with myocarditis in all patients, and most patients also demonstrated findings consistent with myocardial edema. Cardiac biopsy, performed in 1 of the patients before steroid initiation, did not demonstrate myocardial infiltrate. All patients had resolution of their chest pain, were discharged from the hospital in stable condition, and were alive with preserved left ventricular ejection fraction at last contact.Table 1. Patient DemographicsPatientVaccine receivedDay of presentationPresenting symptomsBaseline troponin*Peak troponin*CRP*ECGLowest left ventricular ejection fractionMRI findingsAnti-inflammatory treatmentClinical course122 y; male; White (United States)mRNA-12733 days after 2nd doseFever, chills, myalgia on day +1, followed by chest pain day +31042854.8Diffuse ST-segment elevation with depression in aVR50%, generalized hypokinesisPatchy subepicardial delayed enhancementNSAIDs, prednisoneHemodynamically stable, no clinical of heart failure; intermittent chest pain resolved with ibuprofen and steroids231 y; male; White (United States)mRNA-12733 days after 2nd doseFever, chills, myalgia on day +1, chest pain, shortness of breath on day +339.54614Normal ECG34%, generalized hypokinesisPatchy subepicardial and midmyocardial delayed enhancementNoHemodynamically stable, no clinical heart failure; chest pain resolved with acetaminophen; follow-up echocardiogram on day +11 with normal left ventricular function340 y; male; White (United States)BNT162b22 days after 1st doseChest pain1025209.5Diffuse ST-segment elevation with depression in aVR, V147%, generalized hypokinesisEdema, delayed enhancement, pericardial effusionPrednisone, colchicineHemodynamically stable; endomyocardial biopsy found no active myocarditis456 y; male; White (Italy)BNT162b23 days after 2nd doseChest pain21375.8Diffuse peaked T waves60%, inferolateral hypokinesisEdema, delayed enhancementNoHemodynamically stable526 y; male; White (Italy)BNT162b23 days after 2nd doseCough, fever on day +1, chest pain on day +3111001Inferolateral ST elevation60%, inferior wall hypokinesisEdema, delayed enhancement, pericardial effusionColchicine2 days in intensive care; no inotropes or mechanical circulatory support; discharged stable635 y; male; White (Italy)BNT162b22 days after 2nd doseFever on day +1, chest pain on day +218299Diffuse ST-segment elevation with depression in aVR50%, lateral and inferolateral hypokinesisEdema, delayed enhancementNSAIDs4 days in intensive care; no inotropes or mechanical circulatory support; discharged stable721 y; male; White (Italy)BNT162b24 days after 2nd doseFever on day +1, chest pain on day +41.411644.6Diffuse ST-segment elevation54%, inferior and posterolateral hypokinesisEdema, delayed enhancement, pericardial effusion, pericardial edemaNSAIDs2 days in intensive care; no inotropes or mechanical circulatory support; NSVT episode; discharged stable822 y; male; Asian (United States)mRNA-12732 days after 2nd doseChest pain on day +2132714334Inferior, anterolateral ST-elevation53%, inferolateral hypokinesisEdema, delayed enhancementNoNSVT episodes (N=3); discharged stableCRP indicates C-reactive protein; NSAID, nonsteroidal anti-inflammatory drug; and NSVT, nonsustained ventricular tachycardia.* Values are expressed as the multiple of the upper limit of normal for each laboratory’s reference range.The patients presented here demonstrated typical signs, symptoms, and diagnostic features of acute myocarditis. The temporal association between receiving an mRNA-based COVID-19 vaccine and the development of myocarditis is notable. Trials that tested the BNT162b2 and mRNA-1273 vaccines showed that systemic reactogenicity more often occurred after dose 2 and generally within 48 hours after vaccination.1,2 On average, our patients presented with symptoms of acute myocarditis 3 days after the second injection, and in 5 out of 8 patients fever appeared a day before, supporting the hypothesis that myocarditis could be an mRNA vaccine–related adverse reaction. The only patient who experienced myocarditis after the first vaccination had a previous SARS-CoV-2 infection. No eosinophilia was noted in our patients, unlike myocarditis associated with smallpox vaccination.3,4 Potential mechanisms for myocarditis after mRNA-based vaccination include a nonspecific innate inflammatory response or a molecular mimicry mechanism between viral spike protein and an unknown cardiac protein.5 With regard to therapy, 3 patients received NSAIDs, 2 received colchicine, 2 received prednisone, and 3 received no medications. We would consider the use of corticosteroids in fulminant myocarditis because of the likely immune-mediated postvaccination mechanism4; however, corticosteroids could reduce the specific immune response against SARS-CoV-2 that is triggered by the vaccine. Therefore, the duration of corticosteroid administration should be limited to the resolution of the symptoms or ventricular arrhythmias or the recovery of the left ventricular ejection fraction. Pending publication of long-term outcome data after SARS-CoV-2 vaccine–related myocarditis, we suggest adherence to the current consensus recommendation to abstain from competitive sports for a period of 3 to 6 months with re-evaluation before sports participation.4 As a case report collection, the current research letter emphasizes the real incidence of acute myocarditis after COVID-19 mRNA vaccination, which appears to be extremely rare. In fact, the Centers for Disease Control’s Vaccine Adverse Event Reporting System (www.wonder.cdc.gov/vaers.html) received reports of chest pain and myocarditis in 5166 and 399 recipients, respectively, of the BNT162b2 or mRNA-1273 vaccine, whereas more than 129 million people have been fully vaccinated with these 2 vaccines. In conclusion, providers should be vigilant for myocarditis after COVID-19 mRNA vaccination, and further research is required to understand the long-term cardiovascular risks.Sources of FundingNone.Disclosures None.Footnotes*K.F. Larson and E. Ammirati are joint first authors.The podcast and transcript are available as a Data Supplement at https://www.ahajournals.org/doi/suppl/10.1161/CIRCULATIONAHA.121.055913.For Sources of Funding and Disclosures, see page 508.The data that support the findings of this study and research materials, as well as experimental procedures and protocols, are available from the corresponding author upon reasonable request.https://www.ahajournals.org/journal/circCorrespondence to: Kathryn F. Larson, MD, Department of Cardiovascular Medicine, 200 1st St SW, Mayo Clinic, Rochester, MN 55905; Email larson.[email protected]eduEnrico Ammirati, MD, PhD, Niguarda Hospital, Piazza Ospedale Maggiore 3, 20162, Milano, Italy. Email enrico.[email protected]itReferences1. Baden LR, El Sahly HM, Essink B, Kotloff K, Frey S, Novak R, Diemert D, Spector SA, Rouphael N, Creech CB, et al.; COVE Study Group. Efficacy and safety of the mRNA-1273 SARS-CoV-2 vaccine.N Engl J Med. 2021; 384:403–416. doi: 10.1056/NEJMoa2035389CrossrefMedlineGoogle Scholar2. Polack FP, Thomas SJ, Kitchin N, Absalon J, Gurtman A, Lockhart S, Perez JL, Pérez Marc G, Moreira ED, Zerbini C, et al.; C4591001 Clinical Trial Group. Safety and efficacy of the BNT162b2 mRNA Covid-19 vaccine.N Engl J Med. 2020; 383:2603–2615. doi: 10.1056/NEJMoa2034577CrossrefMedlineGoogle Scholar3. Engler RJ, Nelson MR, Collins LC, Spooner C, Hemann BA, Gibbs BT, Atwood JE, Howard RS, Chang AS, Cruser DL, et al.. A prospective study of the incidence of myocarditis/pericarditis and new onset cardiac symptoms following smallpox and influenza vaccination.PLoS One. 2015; 10:e0118283. doi: 10.1371/journal.pone.0118283CrossrefMedlineGoogle Scholar4. Ammirati E, Frigerio M, Adler ED, Basso C, Birnie DH, Brambatti M, Friedrich MG, Klingel K, Lehtonen J, Moslehi JJ, et al.. Management of acute myocarditis and chronic inflammatory cardiomyopathy: an expert consensus document.Circ Heart Fail. 2020; 13:e007405. doi: 10.1161/CIRCHEARTFAILURE.120.007405LinkGoogle Scholar5. Segal Y, Shoenfeld Y. Vaccine-induced autoimmunity: the role of molecular mimicry an immune cross reaction, Cell Mol.Immunol. 2018; 15:586–594. doi: 10.1038/cmi.2017.151Google Scholar Previous Back to top Next FiguresReferencesRelatedDetailsCited ByTruong D, Dionne A, Muniz J, McHugh K, Portman M, Lambert L, Thacker D, Elias M, Li J, Toro-Salazar O, Anderson B, Atz A, Bohun C, Campbell M, Chrisant M, D’Addese L, Dummer K, Forsha D, Frank L, Frosch O, Gelehrter S, Giglia T, Hebson C, Jain S, Johnston P, Krishnan A, Lombardi K, McCrindle B, Mitchell E, Miyata K, Mizzi T, Parker R, Patel J, Ronai C, Sabati A, Schauer J, Sexson Tejtel S, Shea J, Shekerdemian L, Srivastava S, Votava-Smith J, White S and Newburger J (2021) Clinically Suspected Myocarditis Temporally Related to COVID-19 Vaccination in Adolescents and Young Adults: Suspected Myocarditis After COVID-19 Vaccination, Circulation, 145:5, (345-356), Online publication date: 1-Feb-2022.Ammirati E, Lupi L, Palazzini M, Hendren N, Grodin J, Cannistraci C, Schmidt M, Hekimian G, Peretto G, Bochaton T, Hayek A, Piriou N, Leonardi S, Guida S, Turco A, Sala S, Uribarri A, Van de Heyning C, Mapelli M, Campodonico J, Pedrotti P, Barrionuevo Sánchez M, Ariza Sole A, Marini M, Matassini M, Vourc’h M, Cannatà A, Bromage D, Briguglia D, Salamanca J, Diez-Villanueva P, Lehtonen J, Huang F, Russel S, Soriano F, Turrini F, Cipriani M, Bramerio M, Di Pasquale M, Grosu A, Senni M, Farina D, Agostoni P, Rizzo S, De Gaspari M, Marzo F, Duran J, Adler E, Giannattasio C, Basso C, McDonagh T, Kerneis M, Combes A, Camici P, de Lemos J and Metra M (2022) Prevalence, Characteristics, and Outcomes of COVID-19–Associated Acute Myocarditis, Circulation, 145:15, (1123-1139), Online publication date: 12-Apr-2022. Ahmed S, Mohamed M, Essa R, Ahmed Rashad E, Ibrahim P, Khdir A and Wsu Z (2022) Global reports of myocarditis following COVID-19 vaccination: A systematic review and meta-analysis, Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 10.1016/j.dsx.2022.102513, 16:6, (102513), Online publication date: 1-Jun-2022. Giacca M and Shah A (2022) The pathological maelstrom of COVID-19 and cardiovascular disease, Nature Cardiovascular Research, 10.1038/s44161-022-00029-5, 1:3, (200-210), Online publication date: 1-Mar-2022. Chouchana L, Blet A, Al‐Khalaf M, Kafil T, Nair G, Robblee J, Drici M, Valnet‐Rabier M, Micallef J, Salvo F, Treluyer J and Liu P (2021) Features of Inflammatory Heart Reactions Following mRNA COVID‐19 Vaccination at a Global Level, Clinical Pharmacology & Therapeutics, 10.1002/cpt.2499, 111:3, (605-613), Online publication date: 1-Mar-2022. Power J, Keyt L and Adler E (2022) Myocarditis following COVID-19 vaccination: incidence, mechanisms, and clinical considerations, Expert Review of Cardiovascular Therapy, 10.1080/14779072.2022.2066522, 20:4, (241-251), Online publication date: 3-Apr-2022. Tedeschi A, Camilli M, Ianni U, Tavecchia G, Palazzini M, Cartella I, Gentile P, Quattrocchi G, Maria Spanò F, Cipriani M, Garascia A and Ammirati E (2022) Takotsubo syndrome after BNT162b2 mRNA Covid-19 vaccine: Emotional or causative relationship with vaccination?, IJC Heart & Vasculature, 10.1016/j.ijcha.2022.101002, 40, (101002), Online publication date: 1-Jun-2022. Seok J, Na E, Kim S, Park J, Park E, Song P and Yang K (2022) Association Between Suggestive Symptom of Restless Legs Syndrome and COVID-19 Vaccination: A Pilot Study, Journal of Sleep Medicine, 10.13078/jsm.210022, 19:1, (6-11) Parmar K, Mekraksakit P, Del Rio-Pertuz G, Sethi P, Motes A, Hughes M, Wischmeyer J, Carbajal L and Sosa E (2021) Myocarditis following COVID-19 mRNA vaccination, Baylor University Medical Center Proceedings, 10.1080/08998280.2021.1990743, 35:2, (209-213), Online publication date: 4-Mar-2022. Oster M, Shay D, Su J, Gee J, Creech C, Broder K, Edwards K, Soslow J, Dendy J, Schlaudecker E, Lang S, Barnett E, Ruberg F, Smith M, Campbell M, Lopes R, Sperling L, Baumblatt J, Thompson D, Marquez P, Strid P, Woo J, Pugsley R, Reagan-Steiner S, DeStefano F and Shimabukuro T (2022) Myocarditis Cases Reported After mRNA-Based COVID-19 Vaccination in the US From December 2020 to August 2021, JAMA, 10.1001/jama.2021.24110, 327:4, (331), Online publication date: 25-Jan-2022. Kawakami T, Yahagi K, Sekiguchi M, Ishizawa T, Nonaka H, Setoguchi N, Watanabe Y, Nakase M, Horiuchi Y, Asami M, Yuzawa H, Komiyama K, Tanaka J, Aoki J and Tanabe K (2022) Acute Myocarditis in a Patient Following mRNA-1273 SARS-CoV-2 Vaccination, Internal Medicine, 10.2169/internalmedicine.9000-21, 61:9, (1371-1374), Online publication date: 1-May-2022. Gluckman T, Bhave N, Allen L, Chung E, Spatz E, Ammirati E, Baggish A, Bozkurt B, Cornwell W, Harmon K, Kim J, Lala A, Levine B, Martinez M, Onuma O, Phelan D, Puntmann V, Rajpal S, Taub P and Verma A (2022) 2022 ACC Expert Consensus Decision Pathway on Cardiovascular Sequelae of COVID-19 in Adults: Myocarditis and Other Myocardial Involvement, Post-Acute Sequelae of SARS-CoV-2 Infection, and Return to Play, Journal of the American College of Cardiology, 10.1016/j.jacc.2022.02.003, 79:17, (1717-1756), Online publication date: 1-May-2022. Kimball E, Buchwalder K, Upchurch C and Kea B (2022) Intermittent complete heart block with ventricular standstill after Pfizer COVID‐19 booster vaccination: A case report, Journal of the American College of Emergency Physicians Open, 10.1002/emp2.12723, 3:2, Online publication date: 1-Apr-2022. Mohammed L, Dhillon V, Bong J and Patri J Myocarditis Secondary to COVID-19 mRNA Vaccine: A Case Report, Cureus, 10.7759/cureus.22345 Switzer C and Loeb M (2021) Evaluating the relationship between myocarditis and mRNA vaccination, Expert Review of Vaccines, 10.1080/14760584.2022.2002690, 21:1, (83-89), Online publication date: 2-Jan-2022. Lee C and Kong E (2022) FDG PET/MRI of Acute Myocarditis After mRNA COVID-19 Vaccination, Clinical Nuclear Medicine, 10.1097/RLU.0000000000004123, 47:5, (e421-e422), Online publication date: 1-May-2022. Javed A, Medina Y, Tian J, Alvi M, Sahra S and Rojas-Marte G An Unusual Case Of Hemorrhagic Pleuropericarditis After COVID-19 Vaccination, Cureus, 10.7759/cureus.24828 Batatinha H, Baker F, Smith K, Zúñiga T, Pedlar C, Burgess S, Katsanis E and Simpson R (2022) Recent COVID-19 vaccination has minimal effects on the physiological responses to graded exercise in physically active healthy people, Journal of Applied Physiology, 10.1152/japplphysiol.00629.2021, 132:2, (275-282), Online publication date: 1-Feb-2022. Trifan G and Testai F (2022) Neurological Manifestations of Myocarditis, Current Neurology and Neuroscience Reports, 10.1007/s11910-022-01203-9, 22:7, (363-374), Online publication date: 1-Jul-2022. Wang A (2022) Modified mRNA-Based Vaccines Against Coronavirus Disease 2019, Cell Transplantation, 10.1177/09636897221090259, 31, (096368972210902), Online publication date: 1-Jan-2022. Woo W, Kim A, Yon D, Lee S, Hwang J, Jacob L, Koyanagi A, Kim M, Moon D, Jung J, Choi J, Jung S, Eun L, Lee S, Shin J and Smith L (2021) Clinical characteristics and prognostic factors of myocarditis associated with the mRNA COVID‐19 vaccine, Journal of Medical Virology, 10.1002/jmv.27501, 94:4, (1566-1580), Online publication date: 1-Apr-2022. Hajra A, Gupta M, Ghosh B, Ashish K, Patel N, Manek G, Rai D, Sreenivasan J, Goel A, Lavie C and Bandyopadhyay D (2021) Proposed Pathogenesis, Characteristics, and Management of COVID-19 mRNA Vaccine-Related Myopericarditis, American Journal of Cardiovascular Drugs, 10.1007/s40256-021-00511-8, 22:1, (9-26), Online publication date: 1-Jan-2022. Lee A, Balakrishnan I, Khoo C, Ng C, Loh J, Chan L, Teo L and Sim D (2022) Myocarditis Following COVID-19 Vaccination: A Systematic Review (October 2020–October 2021), Heart, Lung and Circulation, 10.1016/j.hlc.2022.02.002, 31:6, (757-765), Online publication date: 1-Jun-2022. Hana D, Patel K, Roman S, Gattas B and Sofka S (2022) Clinical Cardiovascular Adverse Events Reported Post-COVID-19 Vaccination: Are They a Real Risk?, Current Problems in Cardiology, 10.1016/j.cpcardiol.2021.101077, 47:3, (101077), Online publication date: 1-Mar-2022. Chellapandian S, Turkmen S, Salim I, Chinnakaruppan S and Mohammad J (2022) Myocarditis following COVID‐19 mRNA (mRNA‐1273) vaccination, Clinical Case Reports, 10.1002/ccr3.5741, 10:4, Online publication date: 1-Apr-2022. Ahmed S (2022) Myocarditis after BNT162b2 and mRNA-1273 COVID-19 vaccination: A report of 7 cases, Annals of Medicine and Surgery, 10.1016/j.amsu.2022.103657, 77, (103657), Online publication date: 1-May-2022. Sulemankhil I, Abdelrahman M and Negi S (2022) Temporal Association Between the COVID-19 Ad26.COV2.S Vaccine and Acute Myocarditis: A Case Report and Literature Review, Cardiovascular Revascularization Medicine, 10.1016/j.carrev.2021.08.012, 38, (117-123), Online publication date: 1-May-2022. Sun C, Jaffe E and Levi R (2022) Increased emergency cardiovascular events among under-40 population in Israel during vaccine rollout and third COVID-19 wave, Scientific Reports, 10.1038/s41598-022-10928-z, 12:1, Online publication date: 1-Dec-2022. Freise N, Kivel M, Grebe O, Meyer C, Wafaisade B, Peiper M, Zeus T, Schmidt J, Neuwahl J, Jazmati D, Luedde T, Bölke E, Feldt T, Jensen B, Bode J, Keitel V, Haussmann J, Tamaskovics B, Budach W, Fischer J, Knoefel W, Schneider M, Gerber P, Pedoto A, Häussinger D, van Griensven M, Rezazadeh A, Flaig Y, Kirchner J, Antoch G, Schelzig H and Matuschek C (2022) Acute cardiac side effects after COVID-19 mRNA vaccination: a case series, European Journal of Medical Research, 10.1186/s40001-022-00695-y, 27:1, Online publication date: 1-Dec-2022. Maisch B and Dörr R (2022) 2 Jahre COVID-19-Pandemie – was haben wir gelernt?2 years COVID-19 pandemic—What have we learned?, Herz, 10.1007/s00059-022-05097-8, 47:2, (177-193), Online publication date: 1-Apr-2022. Ammirati E, Buono A, Moroni F, Gigli L, Power J, Ciabatti M, Garascia A, Adler E and Pieroni M (2022) State-of-the-Art of Endomyocardial Biopsy on Acute Myocarditis and Chronic Inflammatory Cardiomyopathy, Current Cardiology Reports, 10.1007/s11886-022-01680-x, 24:5, (597-609), Online publication date: 1-May-2022. Raman B, Bluemke D, Lüscher T and Neubauer S (2022) Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus, European Heart Journal, 10.1093/eurheartj/ehac031, 43:11, (1157-1172), Online publication date: 14-Mar-2022. Buske C, Dreyling M, Alvarez-Larrán A, Apperley J, Arcaini L, Besson C, Bullinger L, Corradini P, Giovanni Della Porta M, Dimopoulos M, D’Sa S, Eich H, Foà R, Ghia P, da Silva M, Gribben J, Hajek R, Harrison C, Heuser M, Kiesewetter B, Kiladjian J, Kröger N, Moreau P, Passweg J, Peyvandi F, Rea D, Ribera J, Robak T, San-Miguel J, Santini V, Sanz G, Sonneveld P, von Lilienfeld-Toal M, Wendtner C, Pentheroudakis G and Passamonti F (2022) Managing hematological cancer patients during the COVID-19 pandemic: an ESMO-EHA Interdisciplinary Expert Consensus, ESMO Open, 10.1016/j.esmoop.2022.100403, 7:2, (100403), Online publication date: 1-Apr-2022. Viani G, Pedrotti P, Seregni R, Antonio B, Conte E, Revaiah P, Pavasini R, Demetriades P and Jakstaite A (2022) Effusive–constrictive pericarditis after the second dose of BNT162b2 vaccine (Comirnaty): a case report, European Heart Journal - Case Reports, 10.1093/ehjcr/ytac012, 6:2, Online publication date: 3-Feb-2022. Li M, Wang H, Tian L, Pang Z, Yang Q, Huang T, Fan J, Song L, Tong Y and Fan H (2022) COVID-19 vaccine development: milestones, lessons and prospects, Signal Transduction and Targeted Therapy, 10.1038/s41392-022-00996-y, 7:1, Online publication date: 1-Dec-2022. Bellos I, Karageorgiou V and Viskin D (2022) Myocarditis following mRNA Covid-19 vaccination: A pooled analysis, Vaccine, 10.1016/j.vaccine.2022.02.017, 40:12, (1768-1774), Online publication date: 1-Mar-2022. Nam S, Jeon S, Lee H, Lim H, Lee D and Yoo S (2022) Demographic and Clinical Factors Associated With Anti–SARS-CoV-2 Antibody Levels After 2 BNT162b2 mRNA Vaccine Doses, JAMA Network Open, 10.1001/jamanetworkopen.2022.12996, 5:5, (e2212996) Nguyen Nguyen N, Assad J, Femia G, Schuster A, Otton J and Nguyen T (2022) Role of cardiac magnetic resonance imaging in troponinemia syndromes, World Journal of Cardiology, 10.4330/wjc.v14.i4.190, 14:4, (190-205), Online publication date: 26-Apr-2022. Bozkurt B, Kamat I and Hotez P (2021) Myocarditis With COVID-19 mRNA Vaccines, Circulation, 144:6, (471-484), Online publication date: 10-Aug-2021.Muthukumar A, Narasimhan M, Li Q, Mahimainathan L, Hitto I, Fuda F, Batra K, Jiang X, Zhu C, Schoggins J, Cutrell J, Croft C, Khera A, Drazner M, Grodin J, Greenberg B, Mammen P, Morrison S and de Lemos J (2021) In-Depth Evaluation of a Case of Presumed Myocarditis After the Second Dose of COVID-19 mRNA Vaccine, Circulation, 144:6, (487-498), Online publication date: 10-Aug-2021. Nguyen T, Mall G, Westphal J, Weingärtner O, Möbius‐Winkler S and Schulze P (2021) Acute myocarditis after COVID‐19 vaccination with mRNA‐1273 in a patient with former SARS‐CoV‐2 infection, ESC Heart Failure, 10.1002/ehf2.13613, 8:6, (4710-4714), Online publication date: 1-Dec-2021. Williams C, Choi J, Hosseini F, Roberts J, Ramanathan K and Ong K (2021) Acute Myocarditis Following mRNA-1273 SARS-CoV-2 Vaccination, CJC Open, 10.1016/j.cjco.2021.07.008, 3:11, (1410-1412), Online publication date: 1-Nov-2021. (2021) mrna-1273/tozinameran, Reactions Weekly, 10.1007/s40278-021-03143-7, 1875:1, (227-227), Online publication date: 1-Oct-2021. Patel Y, Louis D, Atalay M, Agarwal S and Shah N (2021) Cardiovascular magnetic resonance findings in young adult patients with acute myocarditis following mRNA COVID-19 vaccination: a case series, Journal of Cardiovascular Magnetic Resonance, 10.1186/s12968-021-00795-4, 23:1, Online publication date: 1-Dec-2021. Abbate A, Gavin J, Madanchi N, Kim C, Shah P, Klein K, Boatman J, Roberts C, Patel S and Danielides S (2021) Fulminant myocarditis and systemic hyperinflammation temporally associated with BNT162b2 mRNA COVID-19 vaccination in two patients, International Journal of Cardiology, 10.1016/j.ijcard.2021.08.018, 340, (119-121), Online publication date: 1-Oct-2021. Matta A, Kunadharaju R, Osman M, Jesme C, McMiller Z, Johnson E, Matta D, Kallamadi R and Bande D Clinical Presentation and Outcomes of Myocarditis Post mRNA Vaccination: A Meta-Analysis and Systematic Review, Cureus, 10.7759/cureus.19240 Kaul R, Sreenivasan J, Goel A, Malik A, Bandyopadhyay D, Jin C, Sharma M, Levine A, Pan S, Fuisz A, Cooper H and Panza J (2021) Myocarditis following COVID-19 vaccination, IJC Heart & Vasculature, 10.1016/j.ijcha.2021.100872, 36, (100872), Online publication date: 1-Oct-2021. Sanchez Tijmes F, Thavendiranathan P, Ude
Referência(s)