There were no differences in left-ventricular ejection fraction (LVEF) (67.0% vs. 46.5 years, p = 0.033), and had higher levels of troponin T (192 vs. Patients with myopericarditis were younger compared to those without (30.5 vs.
These patients presented with ST elevations ( n = 1), ST depressions ( n = 1), raised troponin ( n = 2), and/or mild pericardial effusion on echocardiography ( n = 2). In four of them, CMR ultimately confirmed myopericarditis. In 17 patients, additional CMR was performed for persistent suspicion of myopericarditis. In 96/113 (85%) patients, myopericarditis was ruled out on the basis of normal ECG, echocardiography, and lab values. Symptoms reported after vaccination that triggered evaluation included chest pain ( n = 68, 60%), shortness of breath ( n = 36, 32%), palpitations ( n = 41, 36%), fatigue ( n = 25, 22%), and/or reduced exercise tolerability ( n = 30, 27%). Four patients (4%) received a combination (ChAdOx1 nCoV-19, followed by BNT162b2 mRNA). Forty-nine (43%) patients presented after the first vaccine dose (delay: 25.5 days, 95% CI 18.8–32.1), while the remaining 64 (57%) patients were referred after the second dose (28.6 days 95% CI 20.7–36.5). Cumulative number of patients increased exponentially after the EMA investigation (Fig.
A two-sided p value of ≤ 0.05 was considered statistically significant.īetween Decemand September 3, 2021, a total of 113 patients (age: 45.9 years, 95% CI 43.2–48.7 44% females) were referred to our cardiology practice for suspected myopericarditis after COVID-19 vaccination. Comparisons were performed with Student’s t test and with the Chi-square test for categorical variables. Continuous variables are presented as mean and 95% confidence interval, and categorical variables are represented as frequencies and percentages. Statistical analysis was performed using IBM SPSS Statistics 27.0. Cardiac magnetic resonance (CMR) was performed at the discretion of the treating cardiologist. All patients were scheduled within the 2 following business days and underwent standardized cardiologic assessment including electrocardiography (ECG), echocardiography, and determination of NT-proBNP and high-sensitive troponin T. Since then, we noted increasing requests from General Practitioners for urgent cardiologic consultation of patients with suspected myocarditis after COVID-19 vaccination. On May 7th 2021, the European Medicines Agency (EMA) announced an official investigation of case reports of myopericarditis in temporal relation to COVID-19 vaccination, which was updated on June 11th. In Germany, vaccination against coronavirus disease 2019 (COVID-19) was approved on December 21st 2020 and the first patient treated on December 26th.
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