A Systematic Review of Myocarditis Associated with Covid-19 Mrna Vaccination among Adolescents
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Abstract
The COVID-19 infection which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can lead to severe respiratory illness especially in male adolescents. This systematic review article aimed to compile and illustrate clinical features, diagnostic findings, management, and outcomes manifesting in adolescents in myocarditis associated with mRNA Covid-19. A literature search was accomplished for published eligible articles with MEDLINE and PubMed. All eligible case reports and case series were included from around the world without any language restrictions. For this review, inclusion criteria were confirmed-confirmed SARS-CoV-2 infection cases reporting a diagnosis of myocarditis in adolescents. A total of 6 articles with a total number of 107 patients were included. Patients presented with fatigue, fever, headache, malaise and chest pain. The median age of these patients was 16.23 years. Cardiac biomarkers troponin was raised in almost 78.5% of patients. Elevated C-reactive protein levels were also reported in some of the patients. Electrocardiography results demonstrated ST-segment division while echocardiography showed normal in 4.67% of the studied patients and left ventricular systolic function in 3.74%. Hydroxychloroquine, antiviral therapy, corticosteroids, nonsteroidal anti-inflammatory drugs, intravenous immunoglobin, and glucocorticoids were the most frequent used medications with no death recorded. Common available data on COVID-19 myocarditis among adolescents is limited. Further research is therefore needed to advance the understanding of COVID-19 myocarditis among adolescents.
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References
I. Alghamdi AA. Impact of the COVID-19 pandemic on the social and educational aspects of Saudi university students’ lives. PLOS ONE, 2021; 16(4): e0250026.
II. David JC. Coronavirus disease 2019 (COVID-19). https://emedicine.medscape.com/article/2500114-overview. Retrieved on 16/6/2020.
III. Kaabi MA, Zhang Y, Xia S, Yang Y, Qahtani MM, Abdulrazzaq N, Nusair MA, Hassany M, Jawad JS, Abdalla J, Hussein SE, Mazrouei SK, Karam MA, Li X, Yang X. et al. Effect of 2 inactivated SARS-CoV-2 Vaccines on symptomatic COVID-19 infection in adults: A randomized clinical trial. JAMA, 2021; 326(1): 35-45.
https://doi.org/10.10.1001/jama.2021.8565.
Kashte S. Gulbake A. El-Amin S.F. Gupta, A. (2021). COVID-19 vaccines: rapid development, implications, challenges and future prospects. Human Cell, 34: 711-733.
[Tschope C, Cooper LT, Torre-Amione G, Van Linthout S. Management of myocarditis-related cardiomyopathy in adults. Circulation Research, 2019; 124: 1568-1583.
https://doi.org/10.1161/CIRCRESAHA.118.313578.
Fung G, Luo H, Qui Y, Yang D, McManus B. Myocarditis. Circulation Research, 2016; 118:496-516. https://doi.org/10.1161/CIRCRESAHA.115.306573.
IV. Cassimatis DC, Atwood JE, Engier RM, Linz PE, Grabenstein JD, Vernalis MN. Smallpox vaccination and myopericarditis: a clinical review. J. Am.Coll. Cardiol., 2004;
https://doi.org/10.1161/j.jacc.2003.11.053.
V. Daniels CJ, Rajpal S, Greenshields JT, Rosenthal GL, Chung EH, Terrin M, Jeudy J, Mattson SE, Law IH, Borchers J. et al. Prevalence of clinical and subclinical myocarditis in competitive athletes with recent SARS-CoV-2 infection: Results from the big ten COVID-19 cardiac registry. Curt. J. 2021; 6(9): 1078-1087.
https://doi.org/10.1001/jamacardio.2021.2065.
VI. Dominguez-Rodringuez S. A Bayesian model to predict COVID-19 severity in children. Infect. Dis. J. 2021; 40(8): e287-e293.
https://doi.org/10.1097/INF.00000000000003204.
VII. Truong DT, Dionne A, Muniz CJ, McHugh KE, Portman MA, Lambert LM, Li JS, Toro-Salazar OH, Anderson BR. et al. Clinically suspected myocarditis temporally related to COVID-19 vaccination in adolescents and young adults: Suspected myocarditis after COVID-19 vaccination. 2021; 145: 345-356.
https://doi.org/10.1161/CIRCULATIONAHA.121.056583.
VIII. Marshall M, Ferguson ID, Lewis P, Jaggi P, Gagliardo C, Collins JS, Shaughnessy R, Caron R, Fuss C, Corbin KJ, Emuren L. et al. Symptomatic acute myocarditis in 7 adolescents after Pfizer BioNTech COVID-19 vaccination. Pediatrics, 2021; 148(3): e2021052478.
https://doi.org/10.1542/peds.2021-052478.
IX. Ambati S, Colon M, Mihic M, Sanchez J, Baker A. Acute myopericarditis after COVID-19 vaccine in teenagers. Case Rep. Cardiol., 2021; 20: 8268755.
X. Jain S, Steele JM, Fonseca B, Huang S, Shah S, Maskatia SA, Budhe S, Misra N, Ramachandran P, Gaur L, Eshtehardi P, Anwar S, Kaushik N, Han F, Chaudhuri NR, Grosse-Wortmann L. COVID-19 vaccination associated myocarditis in adolescents. Pediatrics, 2021; 148(5): e2021053428. https://doi.org/10.1542/peds.2021-053427.
XI. Trogen B. COVID-19 associated myocarditis in an adolescent. Pediatr. Infect. Dis. J., 2020; 39(8): e204-e205. https://doi.org/10.1097/INF.000000000000002788.
XII. Gneechi M, Moretti F, Bassi EM, Leonardi S, Totaro R, Perotti L, Zuccaro V, Perlini S, Preda L, Baldanti F, Bruno R, Visconti LO. Myocarditis in a 16-year old boy positive for SARS-CoV-2. Lancet, 2020; 395(10242): e116.
https://doi.org/10.1016/S0140-6736(20)31307-6.
XIII. Fried JA, Ramasubbu K, Bhatt R, Topkara VK, Clerkin KJ, Horn E. et al. The variety of cardiovascular presentations of COVID-19. Circulation, 2020; 141:1930-1966.
Doi:10.1161/CIRCULATIONAHA.120.047164.
XIV. Driggin E, Madhavan MV, Bikdeli B, Church T, Laracy J, Biondi-Zoccai G. et al. Cardiovascular considerations during the COVID-19 pandemic. J Am College Cardiol. 2020; 75:2352-71. Doi:10.1016/j.jacc.2020.03.031.
XV. Omidi F, Hajikhani B, Kazemi SN, Tajbakhsh A, Riazi S, Mirsaeidi M, Ansari A, Boroujeni MG, Khalili F, Hadadi S, Nasiri MJ. Covid-19 and cardiomyopathy: A systematic review. Front. Cardiovasc. Med. 2021;