Cardiac Complications

OpenSAFELY: Effectiveness of COVID-19 vaccination in children and adolescents

Amongst 283,422 previously unvaccinated children and 132,462 children who had received a first vaccine dose, COVID-19-related outcomes were too rare to allow IRRs to be estimated precisely. A&E attendance and unplanned hospitalisation were slightly higher after first vaccination (IRRs versus no vaccination 1.05 (1.01-1.10) and 1.10 (0.95-1.26) respectively) but slightly lower after second vaccination (IRRs versus first dose 0.95 (0.86-1.05) and 0.78 (0.56-1.08) respectively). There were no COVID-19-related deaths in any group. Fewer than seven (exact number redacted) COVID-19-related critical care admissions occurred in the adolescent first dose vs unvaccinated cohort. Among both adolescents and children, myocarditis and pericarditis were documented only in the vaccinated groups, with rates of 27 and 10 cases/million after first and second doses respectively.

Conclusion BNT162b2 vaccination in adolescents reduced COVID-19 A&E attendance and hospitalisation, although these outcomes were rare. Protection against positive SARS-CoV-2 tests was transient.

Case of Myocarditis, Pericarditis, and Fatal Aortic Dissection Following Covid-19 vaccination

Pre-Print

Quote:

“However, currently, a standard method of reporting myocarditis and cardiac adverse events, incidence rate, and follow-up findings does not exist, but gaps do exist in many current studies.

For instance, myocarditis patients selected for research studies typically restrict the inclusion of patients who have presented with myocarditis within 7 to 14 days of vaccination, and many only include myocarditis cases that take place after the second dose.

Yet, it has been shown that myocarditis incidence after COVID-19 vaccination is often known to take place after the first dose, and it can take place within 28 days and sometimes up to 90 days after the second dose.

We should also point out that many studies include only myocarditis participants with raised troponin levels, even though elevated troponin levels have been reported as an unreliable biomarker of myocarditis.

For instance, the pathology of the young man whose medical case we present herein shows raised myoglobulin markers without raised troponin markers. Again, the biological markers and the sophisticated imaging techniques described above

have revealed even subclinical cases or asymptomatic cases. Still, it is important to remember that not all cities and communities have access to this testing, and many cases will remain undetected. In the case presented herein and in the relevant data, we found that the above factors can exclude even serious myocarditis cases from research studies, and we also learned that cases may go undetected, untreated, and excluded from statistical analysis.”

Determinants of COVID-19 vaccine-induced myocarditis

Conclusion:

COVID-19 vaccination is strongly associated with a serious adverse safety signal of myocarditis, particularly in children and young adults resulting in hospitalization and death. Further investigation into the underlying mechanisms of COVID-19 vaccine-induced myocarditis is imperative to create effective mitigation strategies and ensure the safety of COVID-19 vaccination programs across populations.

Commentary: raised c-troponin levels as a sign of myocardial injury after COVID-19 vaccination in healthy individuals are worrying

Conclusions

The claim that the extent of myocardial injury after COVID-19 infection would be higher than after vaccination is not supported by empirical evidence and therefore wrong. We conclude that cross-national systematic observational studies should be conducted that allow a more precise estimation of the risk–benefit ratio of COVID-19 mRNA vaccinations.

Cardiac side effects of RNA-based SARS-CoV-2 vaccines: Hidden cardiotoxic effects of mRNA-1273 and BNT162b2 on ventricular myocyte function and structure

Cardiomyopathy following Covid19 vaccination

A Systematic Review of COVID-19 Vaccine-Induced Takotsubo Cardiomyopathy: A 2023 Update

Takotsubo Cardiomyopathy or broken heart syndrome

Cardiac side effects of RNA-based SARS-CoV-2 vaccines: Hidden cardiotoxic effects of mRNA-1273 and BNT162b2 on ventricular myocyte function and structure

Conclusion: Here, we demonstrated for the first time, that in isolated cardiomyocytes, both mRNA-1273 and BNT162b2 induce specific dysfunctions that correlate pathophysiologically to cardiomyopathy. Both RyR2 impairment and sustained PKA activation may significantly increase the risk of acute cardiac events.

Case Report: Two Case Reports of Pulmonary Hypertension after mRNA COVID-19 Vaccination

We present here two novel cases of sudden onset pulmonary hypertension without evidence of pulmonary emboli, both of which occurred after receiving a COVID-19 mRNA vaccine.

The Incidence of Myocarditis and Pericarditis in Post COVID-19 Unvaccinated Patients—A Large Population-Based Study

An Israeli peer reviewed study shows no increases in myocarditis or pericarditis following Covid-19 infection

Sex-specific differences in myocardial injuryincidence after COVID-19 mRNA-1273booster vaccination

1 in 35 show elevated troponin following vaccination. Among 777 participants (median age 37 years, 69.5% women), 40 participants (5.1%; 95% confidenceinterval [CI] 3.7–7.0%) had elevated hs-cTnT concentration on day 3 and mRNA-1273 vaccine-associated myocardialinjury was adjudicated in 22 participants (2.8% [95% CI1.7–4.3%]