Clinical and Multimodal Imaging Follow-up of Patients with Myopericarditis Following Mrna Covid-19 Vaccination

ABSTRACT

Background: Myopericarditis following coronavirus disease-2019 (COVID-19) vaccine is a described entity, but its evolution is still unclear. Method(s) Patients with a diagnosis of myopericarditis after mRNA COVID-19 vaccine represented our population. Clinical evaluation, laboratory tests and non-invasive cardiac tests were performed at baseline and at six months. Result(s) Between January and August 2021, we identified 7 patients with myopericarditis following mRNA vaccination. The median age was 29 years (IQR 25.5-53.5 years) and all patients were males. The median time from vaccine administration to symptoms onset was 5 days (IQR 4-7 days);five patients received BNT162b2, two mRNA-1273 and only one patient developed symptoms after first dose of vaccine. The most common symptoms at presentation were chest pain (100%) and fatigue (71.4%). Left Ventricular Ejection Fraction (LVEF) was preserved in 6 of them while was mildly reduced in one (median LVEF 61.3% [IQR 60-62.9%]). Late Gadolinium Enhancement was detected at Cardiac Magnetic Resonance in the 42.9% of cases. Treatment was conservative for all patients except one;a pericardiocentesis was necessary due to massive pericardial effusion. At six months follow-up all patients were asymptomatic with normal troponin level, electrocardiogram and echocardiogram confirming the complete healing of the inflammatory process. Two patients received a COVID-19 vaccine booster dose without evidence of myopericardial involvement. Conclusion(s) Myopericarditis associated with mRNA COVID19 vaccination is more frequent in young males and is usually characterized by a benign evolution. (Figure Presented).