COVID-19 Vaccination–Associated Myocarditis in Adolescents

  • Supriya S. Jain
    aNew York Medical College and Maria Fareri Children’s Hospital at Westchester Medical Center, Valhalla, New York
  • Jeremy M. Steele
    bSchool of Medicine, Yale University, New Haven, Connecticut
  • Brian Fonseca
    cColorado Children’s Hospital, Aurora, Colorado
  • Sihong Huang
    dCollege of Human Medicine, Michigan State University and Helen DeVos Children’s Hospital, Spectrum Health, Grand Rapids, Michigan
  • Sanket Shah
    eChildren’s Mercy Hospital, Kansas City, Missouri
  • Shiraz A. Maskatia
    fSchool of Medicine, Stanford University and Lucile Packard Children’s Hospital, Palo Alto, California
  • Sujatha Buddhe
    gSeattle Children’s Hospital and University of Washington, Seattle, Washington
  • Nilanjana Misra
    hCohen Children’s Medical Center of New York, Northwell Health, Queens, New York
  • Preeti Ramachandran
    iUniversity of Kentucky, Lexington, Kentucky
  • Lasya Gaur
    jSchool of Medicine, John Hopkins University, Baltimore, Maryland
  • Parham Eshtehardi
    kNorthside Heart and Vascular Institute, Northside Hospital, Atlanta, Georgia
  • Shafkat Anwar
    lUniversity of California, San Francisco, San Francisco, California
  • Neeru Kaushik
    mUniversity of California, San Francisco Benioff Children’s Hospitals, Oakland, California
  • Frank Han
    nCollege of Medicine, University of Illinois, Peoria, Illinois
  • Nita Ray Chaudhuri
    oWest Virginia University, Morgantown, West Virginia
  • Lars Grosse-Wortmann
    pOregon Health and Science University, Portland, Oregon

説明

<jats:sec> <jats:title>OBJECTIVES</jats:title> <jats:p>In this study, we aimed to characterize the clinical presentation, short-term prognosis, and myocardial tissue changes as noted on cardiovascular magnetic resonance (CMR) or cardiac MRI in pediatric patients with coronavirus disease 2019 vaccination-associated myocarditis (C-VAM).</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>In this retrospective multicenter study across 16 US hospitals, patients &lt;21 years of age with a diagnosis of C-VAM were included and compared with a cohort with multisystem inflammatory syndrome in children. Younger children with C-VAM were compared with older adolescents.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>Sixty-three patients with a mean age of 15.6 years were included; 92% were male. All had received a messenger RNA vaccine and, except for one, presented after the second dose. Four patients had significant dysrhythmia; 14% had mild left ventricular dysfunction on echocardiography, which resolved on discharge; 88% met the diagnostic CMR Lake Louise criteria for myocarditis. Myocardial injury as evidenced by late gadolinium enhancement on CMR was more prevalent in comparison with multisystem inflammatory syndrome in children. None of the patients required inotropic, mechanical, or circulatory support. There were no deaths. Follow-up data obtained in 86% of patients at a mean of 35 days revealed resolution of symptoms, arrhythmias, and ventricular dysfunction.</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>Clinical characteristics and early outcomes are similar between the different pediatric age groups in C-VAM. The hospital course is mild, with quick clinical recovery and excellent short-term outcomes. Myocardial injury and edema are noted on CMR. Close follow-up and further studies are needed to understand the long-term implications and mechanism of these myocardial tissue changes.</jats:p> </jats:sec>

収録刊行物

  • Pediatrics

    Pediatrics 148 (5), 2021-11-01

    American Academy of Pediatrics (AAP)

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