Myocarditis?
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https://pubmed.ncbi.nlm.nih.gov/32127272/
Viral myocarditis has an incidence rate of 10 to 22 per 100,000 individuals. The presentation pattern of viral myocarditis can range from nonspecific symptoms of fatigue and shortness of breath to more aggressive symptoms that mimic acute coronary syndrome.
https://www.tctmd.com/news/true-myocarditis-uncommon-covid-19-review-concludes
Among patients with COVID-19, the incidence of myocarditis is less than 5%, according to a review paper that looked at evidence from tissue taken either at autopsy or endomyocardial biopsy.
Coronavirus-related myocarditis has been a topic of concern over the last year, beginning with small postmortem reports from Wuhan, China, of fulminant myocarditis in some patients, followed by publication of a controversial cardiac magnetic resonance (CMR) study suggesting that more than three-quarters of middle-age adults—some with mild or no symptoms—had ongoing cardiac involvement weeks or even months after recovering from COVID-19. There also was some evidence even among young adults, with a small analysis of 26 college competitive athletes who’d tested positive for the virus showing that four had CMR imaging evidence of myocarditis and eight had signs of prior myocardial injury.
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“I am fond of pigs. Dogs look up to us. Cats look down on us. Pigs treat us as equals.” ~Winston S. Churchill
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@mik said in Myocarditis?:
OK, so that is .0001 to .00022 in the general population, which could make .00057 slightly worrisome in such a younger, fitter population.
Might some of them have had Covid? It looks as though Covid has a much higher risk than vaccination, and the vaccine isn't 100% effective.
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The potential impact of the Delta variant is becoming a reality. God help the unavaccinated and even those who had Covid with no vaccine already in the US.
https://www.themoscowtimes.com/2021/06/23/russia-warns-of-explosive-virus-surge-a74317
And remember the first Pfizer and Moderna shot is only 33% effective against the Delta variant so you have a month to sweat it out.
Any discussion of myocarditis needs to be paired with Delta variant data.
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Myocarditis after Vaccine happens, but more common after COVID.
The Pfizer-BioNTech Covid-19 vaccine is associated with an increased risk of myocarditis, an inflammation of the heart muscle, a large new study from Israel confirms. But the side effect remains rare, and Covid-19 is more likely to cause myocarditis than the vaccine is, scientists reported on Wednesday.
The research, which is based on the electronic health records of about two million people who are 16 or older, provides a comprehensive look at the real-wold incidence of various adverse events after both vaccination and infection with the coronavirus.
Although the study did not break down the myocarditis risks by age or by sex, the median age of people who developed the condition after vaccination was 25, and 19 of the 21 cases were in males, the researchers reported.
In addition to myocarditis, the Pfizer vaccine was also associated with an increased risk of swollen lymph nodes, appendicitis and shingles, although all three side effects remained uncommon in the study. Coronavirus infection was not associated with these side effects, but it did increase the odds of several potentially serious cardiovascular problems, including heart attacks and blood clots.
“Coronavirus is very dangerous, and it’s very dangerous to the human body in many ways,” said Ben Reis, a co-author of the new study and the director of the predictive medicine group at the Boston Children’s Hospital Computational Health Informatics Program.
He added, “If the reason that someone so far has been hesitating to get the vaccine is fear of this very rare and usually not very serious adverse event called myocarditis, well, this study shows that that very same adverse event is actually associated with a higher risk if you’re not vaccinated and you get infected.”
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Myocarditis after Covid-19 mRNA Vaccination
To the Editor:
The Centers for Disease Control and Prevention recently reported cases of myocarditis and pericarditis in the United States after coronavirus disease 2019 (Covid-19) messenger RNA (mRNA) vaccination.1 In recently published reports, diagnosis of myocarditis was made with the use of noninvasive imaging and routine laboratory testing.2-5 Here, we report two cases of histologically confirmed myocarditis after Covid-19 mRNA vaccination.
Patient 1, a 45-year-old woman without a viral prodrome, presented with dyspnea and dizziness 10 days after BNT162b2 vaccination (first dose). A nasopharyngeal viral panel was negative for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), influenza A and B, enteroviruses, and adenovirus (Table S1 in the Supplementary Appendix, available with the full text of this letter at NEJM.org). A serum polymerase-chain-reaction (PCR) assay and serologic tests showed no evidence of active parvovirus, enterovirus, human immunodeficiency virus, or infection with SARS-CoV-2. At presentation, she had tachycardia; ST-segment depression detected on electrocardiography, which was most prominent in the lateral leads (Fig. S1); and a troponin I level of 6.14 ng per milliliter (reference range, 0 to 0.30). A transthoracic echocardiogram showed severe global left ventricular systolic dysfunction (ejection fraction, 15 to 20%) and normal left ventricular dimensions. Right heart catheterization revealed elevated right- and left-sided filling pressures and a cardiac index of 1.66 liters per minute per square meter of body-surface area as measured by the Fick method. Coronary angiography revealed no obstructive coronary artery disease. An endomyocardial biopsy specimen showed an inflammatory infiltrate predominantly composed of T-cells and macrophages, admixed with eosinophils, B cells, and plasma cells ( and Figs. S2 through S4). She received inotropic support, intravenous diuretics, methylprednisolone (1 g daily for 3 days), and, eventually, guideline-directed medical therapy for heart failure (lisinopril, spironolactone, and metoprolol succinate). Seven days after presentation, her ejection fraction was 60%, and she was discharged home.
Patient 2, a 42-year-old man, presented with dyspnea and chest pain 2 weeks after mRNA-1273 vaccination (second dose). He did not report a viral prodrome, and a PCR test was negative for SARS-CoV-2 (Table S1). He had tachycardia and a fever, and his electrocardiogram showed diffuse ST-segment elevation (Fig. S1). A transthoracic echocardiogram showed global biventricular dysfunction (ejection fraction, 15%), normal ventricular dimensions, and left ventricular hypertrophy. Coronary angiography revealed no coronary artery disease. Cardiogenic shock developed in the patient, and he died 3 days after presentation. An autopsy revealed biventricular myocarditis ( and Figs. S5 and S6). An inflammatory infiltrate admixed with macrophages, T-cells, eosinophils, and B cells was observed, a finding similar to that in Patient 1.
In these two adult cases of histologically confirmed, fulminant myocarditis that had developed within 2 weeks after Covid-19 vaccination, a direct causal relationship cannot be definitively established because we did not perform testing for viral genomes or autoantibodies in the tissue specimens. However, no other causes were identified by PCR assay or serologic examination.
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"Now look here, you Baltic gas passer... " - Mik, 6/14/08
The saying, "Lite is just one damn thing after another," is a gross understatement. The damn things overlap.
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@george-k said in Myocarditis?:
And, in a related story, at least one country has recommended NOT giving the Moderna vaccine to adolescents because of the risk of myocarditis.
CDC:
Is it safe to vaccinate adolescents with the COVID-19 vaccine?
COVID-19 vaccines are safe and effective.
COVID-19 vaccines have been used under the most intensive safety monitoring in U.S. history, which includes studies in adolescents.
Sweden and Norway - no Moderna under 30
Denmark - no Moderna under 18Those must be Trump countries
