Myocarditis, Pericarditis 2X more likely if had COVID vaccination in previous 30 days - meta-analysis June 2023


Risk of myocarditis and pericarditis in mRNA COVID-19-vaccinated and unvaccinated populations: a systematic review and meta-analysis

BMJ Open 2023;13:e065687. doi: 10.1136/bmjopen-2022-065687
Abdallah Alami1, Daniel Krewski2,3, Nawal Farhat1, Donald Mattison2,3,4, Kumanan Wilson5,6, Christopher A Gravel2,7,8, Patrick J Farrell1, James A G Crispo9,10, Nisrine Haddad2, Santiago Perez-Lloret11,12,13, Paul J Villeneuve14 Correspondence to Abdallah Alami; abdallahalami@cmail.carleton.ca

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Objective To summarise the available evidence on the risk of myocarditis and/or pericarditis following mRNA COVID-19 vaccination, compared with the risk among unvaccinated individuals in the absence of COVID-19 infection.

Design Systematic review and meta-analysis.

Data sources Electronic databases (Medline, Embase, Web of Science and WHO Global Literature on Coronavirus Disease), preprint repositories (medRxiv and bioRxiv), reference lists and grey literature were searched from 1 December 2020 until 31 October 2022.

Study selection Epidemiological studies of individuals of any age who received at least one dose of an mRNA COVID-19 vaccine, reported a risk of myo/pericarditis and compared the risk of myo/pericarditis to individuals who did not receive any dose of an mRNA COVID-19 vaccine.

Data extraction and synthesis Two reviewers independently conducted screening and data extraction. The rate of myo/pericarditis among vaccinated and unvaccinated groups was recorded, and the rate ratios were calculated. Additionally, the total number of individuals, case ascertainment criteria, percentage of males and history of SARS-CoV-2 infection were extracted for each study. Meta-analysis was done using a random-effects model.

Results Seven studies met the inclusion criteria, of which six were included in the quantitative synthesis. Our meta-analysis indicates that within 30-day follow-up period, vaccinated individuals were twice as likely to develop myo/pericarditis in the absence of SARS-CoV-2 infection compared to unvaccinated individuals, with a rate ratio of 2.05 (95% CI 1.49–2.82).

Conclusion Although the absolute number of observed myo/pericarditis cases remains quite low, a higher risk was detected in those who received mRNA COVID-19 vaccinations compared with unvaccinated individuals in the absence of SARS-CoV-2 infection. Given the effectiveness of mRNA COVID-19 vaccines in preventing severe illnesses, hospitalisations and deaths, future research should focus on accurately determining the rates of myo/pericarditis linked to mRNA COVID-19 vaccines, understanding the biological mechanisms behind these rare cardiac events and identifying those most at risk.
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VitaminDWiki - 19 studies in both categories Virus and Cardiovascular

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