Nuri Lee MD , Kye Hun Kim MD, PhD , Jae-Hyeong Park MD, PhD , Jae Yeong Cho MD, PhD , Soo Hyeon Cho MPH , Dong Keun Kim MD , Seung Yun Kim MD , Eun Kyoung Kim MS , Eui-Young Choi MD, PhD , Jin-Oh Choi MD, PhD , Suji Cho MD , Ga Hui Choi MD , Hyukjin Park MD, PhD , Hyung Yoon Kim MD, PhD , Hyun Ju Yoon MD, PhD , Youngkeun Ahn MD, PhD , Myung Ho Jeong MD, PhD
{"title":"COVID-19 Vaccination–Related Pericarditis","authors":"Nuri Lee MD , Kye Hun Kim MD, PhD , Jae-Hyeong Park MD, PhD , Jae Yeong Cho MD, PhD , Soo Hyeon Cho MPH , Dong Keun Kim MD , Seung Yun Kim MD , Eun Kyoung Kim MS , Eui-Young Choi MD, PhD , Jin-Oh Choi MD, PhD , Suji Cho MD , Ga Hui Choi MD , Hyukjin Park MD, PhD , Hyung Yoon Kim MD, PhD , Hyun Ju Yoon MD, PhD , Youngkeun Ahn MD, PhD , Myung Ho Jeong MD, PhD","doi":"10.1016/j.mayocp.2024.03.026","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the incidence, characteristics, and outcomes of COVID-19 vaccine–related pericarditis (VRP) without myocarditis, we analyzed nationwide Korean data.</div></div><div><h3>Patients and Methods</h3><div>This is a retrospective nationwide report including all vaccinated Koreans with COVID-19 vaccine of any platform (BNT162b2, mRNA-1273, ChAdOx1, or Ad26.COV2.S) from February 26 to December 31, 2021. We analyzed the confirmed cases of COVID-19 VRP by the Expert Adjudication Committee. The incidence, clinical characteristics, and outcomes of COVID-19 VRP were analyzed.</div></div><div><h3>Results</h3><div>Among 44,322,068 Koreans with least one dose of COVID-19 vaccination, COVID-19 VRP was confirmed in 179 cases, with 1.73 per million shots (95% CI, 1.48 to 2.00 per million shots). The incidence of VRP was significantly higher in males than females (2.01 per 1 million doses vs 1.45 per 1 million doses, respectively; <em>P</em>=.029), in mRNA vaccines than in other vaccines (2.09 per 1 million doses vs 0.36 per 1 million doses, respectively; <em>P</em><.001), and in those younger than 40 years of age than those older than 40 years of age (3.52 per 1 million doses vs 0.89 per 1 million doses, respectively; <em>P</em><.001). The incidence of VRP was highest in males between the ages of 12 and 17 years (7.38 per 1 million doses; 95% CI, 2.01 to 16.07). Although there was no case of mortality, hemodynamically significant pericardial effusion requiring pericardial drainage was noted in 10 cases (5.6%).</div></div><div><h3>Conclusion</h3><div>COVID-19 VRP was very rare and developed mainly in association with mRNA vaccines, especially in males younger than 40 years of age. The clinical course of VRP was excellent, and there were no cases of mortality. However, the development of hemodynamically significant pericardial effusion should be carefully monitored.</div></div>","PeriodicalId":18334,"journal":{"name":"Mayo Clinic proceedings","volume":"99 10","pages":"Pages 1577-1588"},"PeriodicalIF":6.9000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Mayo Clinic proceedings","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0025619624001964","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0
Abstract
Objective
To investigate the incidence, characteristics, and outcomes of COVID-19 vaccine–related pericarditis (VRP) without myocarditis, we analyzed nationwide Korean data.
Patients and Methods
This is a retrospective nationwide report including all vaccinated Koreans with COVID-19 vaccine of any platform (BNT162b2, mRNA-1273, ChAdOx1, or Ad26.COV2.S) from February 26 to December 31, 2021. We analyzed the confirmed cases of COVID-19 VRP by the Expert Adjudication Committee. The incidence, clinical characteristics, and outcomes of COVID-19 VRP were analyzed.
Results
Among 44,322,068 Koreans with least one dose of COVID-19 vaccination, COVID-19 VRP was confirmed in 179 cases, with 1.73 per million shots (95% CI, 1.48 to 2.00 per million shots). The incidence of VRP was significantly higher in males than females (2.01 per 1 million doses vs 1.45 per 1 million doses, respectively; P=.029), in mRNA vaccines than in other vaccines (2.09 per 1 million doses vs 0.36 per 1 million doses, respectively; P<.001), and in those younger than 40 years of age than those older than 40 years of age (3.52 per 1 million doses vs 0.89 per 1 million doses, respectively; P<.001). The incidence of VRP was highest in males between the ages of 12 and 17 years (7.38 per 1 million doses; 95% CI, 2.01 to 16.07). Although there was no case of mortality, hemodynamically significant pericardial effusion requiring pericardial drainage was noted in 10 cases (5.6%).
Conclusion
COVID-19 VRP was very rare and developed mainly in association with mRNA vaccines, especially in males younger than 40 years of age. The clinical course of VRP was excellent, and there were no cases of mortality. However, the development of hemodynamically significant pericardial effusion should be carefully monitored.
期刊介绍:
Mayo Clinic Proceedings is a premier peer-reviewed clinical journal in general medicine. Sponsored by Mayo Clinic, it is one of the most widely read and highly cited scientific publications for physicians. Since 1926, Mayo Clinic Proceedings has continuously published articles that focus on clinical medicine and support the professional and educational needs of its readers. The journal welcomes submissions from authors worldwide and includes Nobel-prize-winning research in its content. With an Impact Factor of 8.9, Mayo Clinic Proceedings is ranked #20 out of 167 journals in the Medicine, General and Internal category, placing it in the top 12% of these journals. It invites manuscripts on clinical and laboratory medicine, health care policy and economics, medical education and ethics, and related topics.