Clinical Profiles and CMR Findings of Young Adults and Pediatrics with Acute Myocarditis Following mRNA COVID-19 Vaccination: A Case Series
Roberto Manfredi,
Francesco Bianco,
Valentina Bucciarelli,
Giuseppe Ciliberti,
Federico Guerra,
Nicolò Schicchi,
Marcello Tavio,
Emanuela Berton,
Francesca Chiara Surace,
Massimo Colaneri,
Sabina Gallina,
Marco Pozzi
Affiliations
Roberto Manfredi
Cardiology and Arrhythmology Clinic, University Hospital “Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60123 Ancona, Italy
Francesco Bianco
Department of Pediatric and Congenital Cardiology and Cardiac Surgery—Azienda Ospedaliero, Universitaria “Ospedali Riuniti” di Ancona, 60123 Ancona, Italy
Valentina Bucciarelli
Department of Pediatric and Congenital Cardiology and Cardiac Surgery—Azienda Ospedaliero, Universitaria “Ospedali Riuniti” di Ancona, 60123 Ancona, Italy
Giuseppe Ciliberti
Cardiology and Arrhythmology Clinic, University Hospital “Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60123 Ancona, Italy
Federico Guerra
Cardiology and Arrhythmology Clinic, University Hospital “Umberto I-Lancisi-Salesi”, Marche Polytechnic University, 60123 Ancona, Italy
Unit of Emerging and Immunosuppressed Infectious Diseases, Department of Gastroenterology and Transplantation, Polytechnic University of Marche, 60123 Ancona, Italy
Emanuela Berton
Department of Pediatric and Congenital Cardiology and Cardiac Surgery—Azienda Ospedaliero, Universitaria “Ospedali Riuniti” di Ancona, 60123 Ancona, Italy
Francesca Chiara Surace
Department of Pediatric and Congenital Cardiology and Cardiac Surgery—Azienda Ospedaliero, Universitaria “Ospedali Riuniti” di Ancona, 60123 Ancona, Italy
Massimo Colaneri
Department of Pediatric and Congenital Cardiology and Cardiac Surgery—Azienda Ospedaliero, Universitaria “Ospedali Riuniti” di Ancona, 60123 Ancona, Italy
Sabina Gallina
Department of Neurosciences, Imaging and Clinical Sciences, Gabriele d’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy
Marco Pozzi
Department of Pediatric and Congenital Cardiology and Cardiac Surgery—Azienda Ospedaliero, Universitaria “Ospedali Riuniti” di Ancona, 60123 Ancona, Italy
Messenger RNA (mRNA) coronavirus disease of 2019 (COVID-19) vaccines have been recently associated with acute myocarditis, predominantly in healthy young males. Out of 231,989 vaccines administrated in our region (Marche, Italy), we report a case series of six healthy patients (four males and two females, 16.5 years old (Q1, Q3: 15, 18)) that experienced mRNA-COVID-19-vaccines side effects. All patients were hospitalized due to fever and troponins elevation following the second dose of an mRNA-based COVID-19 vaccine. Cardiovascular magnetic resonance (CMR) was performed 72–96 h after vaccination. All patients were treated with colchicine and ibuprofen. Myocarditis was prevalent in males. It was characterized by myocardial edema and late gadolinium enhancement (LGE) in the lateral wall of the left ventricle (LV). One patient showed sole right ventricular involvement, while the females presented with myopericarditis (myocarditis + pericardial effusion). All patients in our series had preserved LV ejection fraction and remained clinically stable during a relatively short inpatient hospital stay. One case presented with atrial tachycardia. At the follow-up, no significant CMR findings were documented after a three-month medical treatment. According to other recently published case series, our report suggests a possible association between acute myocarditis and myopericarditis with mRNA COVID-19 vaccination in healthy young adults and pediatric patients. Not only males are involved, while some arrhythmic manifestations are possible, such as atrial tachycardia. Conversely, we here highlight the benign nature of such complications and the absence of CMR findings after a three-month medical treatment with colchicine and ibuprofen.
