Case Series of Myocarditis Following mRNA COVID Vaccine Compared to Pediatric Multisystem Inflammatory Syndrome: Multicenter Retrospective Study
Yonatan Butbul Aviel,
Philip J. Hashkes,
Yotam Dizitzer,
Kanteman Inbar,
Yackov Berkun,
Eli M. Eisenstein,
Mohamad Hamad Saied,
Ofra Goldzweig,
Merav Heshin-Bekenstein,
Eduard Ling,
Michal Feldon,
Rotem Tal,
Shiran Pinchevski-Kadir,
Irit Tirosh,
Liora Harel,
Gil Amarilyo,
Kfir Kaidar
Affiliations
Yonatan Butbul Aviel
Department of Pediatrics and Pediatric Rheumatology Service, Rambam Health Care Campus, Ruth Children’s Hospital, Haifa 2611001, Israel
Philip J. Hashkes
Pediatric Rheumatology Unit, Shaare Zedek Medical Center, Hebrew University-Hadassah School of Medicine, Jerusalem 9103401, Israel
Yotam Dizitzer
Schneider Children’s Medical Center, Sackler School of Medicine Tel-Aviv University, Tel Aviv 6329302, Israel
Kanteman Inbar
Department of Pediatrics and Pediatric Rheumatology Service, Rambam Health Care Campus, Ruth Children’s Hospital, Haifa 2611001, Israel
Yackov Berkun
Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem 9103401, Israel
Eli M. Eisenstein
Department of Pediatrics, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem 9103401, Israel
Mohamad Hamad Saied
Carmel Medical Center, Technion–Israel Institute of Technology, Haifa 2611001, Israel
Ofra Goldzweig
Kaplan Medical Center, Rehovot, Hebrew University and Hadassa, Jerusalem 9103401, Israel
Merav Heshin-Bekenstein
Pediatric Rheumatology Service, Dana-Dwek Children’s Hospital of Tel Aviv Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv 6329302, Israel
Eduard Ling
Saban Pediatric Medical Center for Israel, Pediatrics Department B, Soroka University Medical Center, Beer Sheva 84417, Israel
Michal Feldon
Shamir Medical Center, Sackler School of Medicine, Tel-Aviv University, Tel Aviv 6329302, Israel
Rotem Tal
Schneider Children’s Medical Center, Sackler School of Medicine Tel-Aviv University, Tel Aviv 6329302, Israel
Shiran Pinchevski-Kadir
Sheba Medical Centre, Tel Hashomer, Sackler Faculty of Medicine, Paediatric Rheumatology Unit and Department of Paediatrics B, Edmond and Lily Safra Children’s Hospital, Tel-Aviv University, Tel-Aviv 6329302, Israel
Irit Tirosh
Sheba Medical Centre, Tel Hashomer, Sackler Faculty of Medicine, Paediatric Rheumatology Unit and Department of Paediatrics B, Edmond and Lily Safra Children’s Hospital, Tel-Aviv University, Tel-Aviv 6329302, Israel
Liora Harel
Schneider Children’s Medical Center, Sackler School of Medicine Tel-Aviv University, Tel Aviv 6329302, Israel
Gil Amarilyo
Schneider Children’s Medical Center, Sackler School of Medicine Tel-Aviv University, Tel Aviv 6329302, Israel
Kfir Kaidar
Schneider Children’s Medical Center, Sackler School of Medicine Tel-Aviv University, Tel Aviv 6329302, Israel
Introduction: Since the development of COVID-19 vaccines, more than 4.8 billion people have been immunized worldwide. Soon after vaccinations were initiated, reports on cases of myocarditis following the second vaccine dose emerged. This study aimed to report our experience with adolescent and young adults who developed post-COVID-19 vaccine myocarditis and to compare these patients to a cohort of patients who acquired pediatric inflammatory multisystem syndrome (PIMS/PIMS-TS) post-COVID-19 infection. Methods: We collected reported cases of patients who developed myocarditis following COVID-19 vaccination (Pfizer mRNA BNT162b2) from all pediatric rheumatology centers in Israel and compared them to a cohort of patients with PIMS. Results: Nine patients with post-vaccination myocarditis were identified and compared to 78 patients diagnosed with PIMS. All patients with post-vaccination myocarditis were males who developed symptoms following their second dose of the vaccine. Patients with post-vaccination myocarditis had a shorter duration of stay in the hospital (mean 4.4 ± 1.9 vs. 8.7 ± 4.7 days) and less myocardial dysfunction (11.1% vs. 61.5%), and all had excellent outcomes as compared to the chronic changes among 9.2% of the patients with PIMS. Conclusion: The clinical course of vaccine-associated myocarditis appears favorable, with resolution of the symptoms in all the patients in our cohort.
