TY - JOUR
T1 - COVID-19 vaccination and carditis in children and adolescents
T2 - a systematic review and meta-analysis
AU - Chou, Oscar Hou In
AU - Mui, Jonathan
AU - Chung, Cheuk To
AU - Radford, Danny
AU - Ranjithkumar, Simon
AU - Evbayekha, Endurance
AU - Nam, Ronald
AU - Pay, Levent
AU - Satti, Danish Iltaf
AU - Garcia-Zamora, Sebastian
AU - Bazoukis, George
AU - Çinier, Göksel
AU - Lee, Sharen
AU - Vassiliou, Vassilios S.
AU - Liu, Tong
AU - Tse, Gary
AU - Wong, Ian Chi Kei
AU - Liu, Tong
N1 - Publisher Copyright:
© 2022, The Author(s).
PY - 2022/10/1
Y1 - 2022/10/1
N2 - Background: Coronavirus Disease-2019 (COVID-19) vaccination has been associated with the development of carditis, especially in children and adolescent males. However, the rates of these events in the global setting have not been explored in a systematic manner. The aim of this systematic review and meta-analysis is to investigate the rates of carditis in children and adolescents receiving COVID-19 vaccines. Methods: PubMed, Embase and several Latin American databases were searched for studies. The number of events, and where available, at-risk populations were extracted. Rate ratios were calculated and expressed as a rate per million doses received. Subgroup analysis based on the dose administered was performed. Subjects ≤ 19 years old who developed pericarditis or myocarditis following COVID-19 vaccination were included. Results: A total of 369 entries were retrieved. After screening, 39 articles were included. Our meta-analysis found that 343 patients developed carditis after the administration of 12,602,625 COVID-19 vaccination doses (pooled rate per million: 37.76; 95% confidence interval [CI] 23.57, 59.19). The rate of carditis was higher amongst male patients (pooled rate ratio: 5.04; 95% CI 1.40, 18.19) and after the second vaccination dose (pooled rate ratio: 5.60; 95% CI 1.97, 15.89). In 301 cases of carditis (281 male; mean age: 15.90 (standard deviation [SD] 1.52) years old) reported amongst the case series/reports, 261 patients were reported to have received treatment. 97.34% of the patients presented with chest pain. The common findings include ST elevation and T wave abnormalities on electrocardiography. Oedema and late gadolinium enhancement in the myocardium were frequently observed in cardiac magnetic resonance imaging (CMR). The mean length of hospital stay was 3.91 days (SD 1.75). In 298 out of 299 patients (99.67%) the carditis resolved with or without treatment. Conclusions: Carditis is a rare complication after COVID-19 vaccination across the globe, but the vast majority of episodes are self-limiting with rapid resolution of symptoms within days. Graphical abstract: Central illustration. Balancing the benefits of vaccines on COVID-19-caused carditis and post-vaccination carditis. [Figure not available: see fulltext.]
AB - Background: Coronavirus Disease-2019 (COVID-19) vaccination has been associated with the development of carditis, especially in children and adolescent males. However, the rates of these events in the global setting have not been explored in a systematic manner. The aim of this systematic review and meta-analysis is to investigate the rates of carditis in children and adolescents receiving COVID-19 vaccines. Methods: PubMed, Embase and several Latin American databases were searched for studies. The number of events, and where available, at-risk populations were extracted. Rate ratios were calculated and expressed as a rate per million doses received. Subgroup analysis based on the dose administered was performed. Subjects ≤ 19 years old who developed pericarditis or myocarditis following COVID-19 vaccination were included. Results: A total of 369 entries were retrieved. After screening, 39 articles were included. Our meta-analysis found that 343 patients developed carditis after the administration of 12,602,625 COVID-19 vaccination doses (pooled rate per million: 37.76; 95% confidence interval [CI] 23.57, 59.19). The rate of carditis was higher amongst male patients (pooled rate ratio: 5.04; 95% CI 1.40, 18.19) and after the second vaccination dose (pooled rate ratio: 5.60; 95% CI 1.97, 15.89). In 301 cases of carditis (281 male; mean age: 15.90 (standard deviation [SD] 1.52) years old) reported amongst the case series/reports, 261 patients were reported to have received treatment. 97.34% of the patients presented with chest pain. The common findings include ST elevation and T wave abnormalities on electrocardiography. Oedema and late gadolinium enhancement in the myocardium were frequently observed in cardiac magnetic resonance imaging (CMR). The mean length of hospital stay was 3.91 days (SD 1.75). In 298 out of 299 patients (99.67%) the carditis resolved with or without treatment. Conclusions: Carditis is a rare complication after COVID-19 vaccination across the globe, but the vast majority of episodes are self-limiting with rapid resolution of symptoms within days. Graphical abstract: Central illustration. Balancing the benefits of vaccines on COVID-19-caused carditis and post-vaccination carditis. [Figure not available: see fulltext.]
KW - COVID-19
KW - Carditis
KW - Myocarditis
KW - Pericarditis
KW - Vaccine
UR - http://www.scopus.com/inward/record.url?scp=85136012076&partnerID=8YFLogxK
U2 - 10.1007/s00392-022-02070-7
DO - 10.1007/s00392-022-02070-7
M3 - Article
AN - SCOPUS:85136012076
SN - 1861-0684
VL - 111
SP - 1161
EP - 1173
JO - Clinical Research in Cardiology
JF - Clinical Research in Cardiology
IS - 10
ER -
